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Joe Rogan Experience #1671 - Bret Weinstein & Dr. Pierre Kory

Dr. Pierre Kory is an ICU and lung specialist who is an expert on the use of the drug ivermectin to treat COVID-19. Bret Weinstein is an evolutionary biologist, visiting fellow at Princeton, host of the DarkHorse podcast, and co-author (with his wife, Heather Heying) of the forthcoming "A Hunter-Gatherer's Guide to the 21st Century."

Dr. Pierre KoryguestBret WeinsteinguestJoe RoganhostGuest (Bret Weinstein or Dr. Pierre Kory)guest
Jun 27, 20242h 54mWatch on YouTube ↗

EVERY SPOKEN WORD

  1. 0:00 – 1:23

    Emergency episode setup: who Dr. Pierre Kory is and why this conversation is urgent

    1. PK

      (drumming) Joe Rogan podcast, check it out.

    2. BW

      The Joe Rogan Experience.

    3. JR

      Train by day, Joe Rogan podcast by night. All day. (rock music plays) So, this is the first of ... I've never had to do an emergency podcast before. But it, I feel like we do. And Brett, you and I have been in communication about this and this se- seemed like something that we have to do quicker than later. Um, let's explain what's going on. Uh, you guys have had conversations, uh, first of all, uh, Dr. Kory, please explain who you are and introduce yourself.

    4. PK

      Yeah, sure. So, (clears throat) I'm a lung and ICU specialist, um, who's part of a group of, um, other ICU specialists. We came together early in the pandemic, uh, to develop treatment protocols for COVID. Um, we first developed a hospital treatment protocol back in March, um, and then more recently, we have an outpatient treatment protocol centered around the drug Ivermectin, and I'll just say, through our work, um, I would say we are probably the foremost experts on the use of Ivermectin and COVID in the world.

    5. JR

      And how did you, uh, Brett, how did you get involved with Dr. Kory, and how did your initial conversation get in, uh, get started? What's ...

  2. 1:23 – 3:06

    Bret Weinstein’s COVID analysis background and how ivermectin entered the picture

    1. BW

      Well, Heather and I have been podcasting on the developing COVID story, uh, for quite some time. We started very early and, uh, we actually, I just took the Dark Horse podcast, which had been just me talking to people, and Heather and I started live streaming twice a week at first. And at first, we were just simply looking at the evidence on COVID, what it is, how it transmits, how it should change your behavior. You know, in those early days, it was scary. We didn't know if it was transmitted on surfaces or what. So, Heather and I just, uh, did our analysis live, or not live. I guess it was live, but in any case, the two of us just, uh, had discussions about what we thought the evidence meant and we presented papers that we were reading in the literature.

    2. JR

      And we should explain your credentials, like what ...

    3. BW

      I'm a, I'm a biologist. I'm an evolutionary biologist. Um, the importance of evolution here is that A, all of the things that we're talking about with COVID are evolutionary. Obviously, the virus is evolved. Epidemiology is an evolutionary, uh, process. The immune system is both a, a product of evolution and it evolves in real time when you have an infection. So, evolution is a kind of good generalist toolkit to apply to something like COVID. But in any case, as we were working through the various emerging evidence and figuring out what we believed and what we didn't and why, we ran into Ivermectin, and there was this indication that it was effective against COVID, and we didn't know what to make of it. We didn't know whether or not there was something-

    4. JR

      What was the, where was the initial indication from?

    5. BW

      I, I can't recall. Actually, Pierre might have some idea where we would've encountered it in, you know, April or ...

    6. PK

      Yeah. Yeah, so ...

    7. BW

      ... 2020.

  3. 3:06 – 4:59

    Early ivermectin signal: lab evidence and “bench to bedside” urgency

    1. PK

      Um, you know, just also, Joe, just for a little bit more background, 'cause I, I do wanna emphasize that, you know, although I'm here today talking, uh, my group, the, the five of us, we call ourselves the, the Front Line COVID-19 Critical Care Alliance, uh, we're led by Dr. Paul Marek, a very famous guy in our specialty. In fact, he's the, uh, most published intensivist in the world. That's what we are, uh, ICU docs. And, um, people came to him to develop protocols, and so he grabbed his, his four closest colleagues and friends of which I'm honored to be one. I'm a good friend of his and, um, he's a mentor to me. And we've studied ... We basically started putting together protocols that we took from other critical illnesses that we're expert at, and we applied them to COVID, and we learned everything we could around COVID. We just read papers and papers and papers, and we followed all the therapeutics that were being trialed and tested around the world, and Ivermectin, the first, uh, paper was last about March or April, but it came out of a lab. It was just like what's called a cell culture model. It wasn't tested in humans. But this cell culture model showed that if you applied Ivermectin to these, uh, it was actually monkey kidney cells, the virus was essentially eradicated within 48 hours. They could find almost no viral material, um, when they used Ivermectin in this cell culture model. Some places around the world took that bench study (laughs) and brought it out into clinical use. And I call that, you know, the bench to the bedside, and if you know anything about medicine development, very few what we call molecules make it from the bench to the bedside. Um, and so ... But it was an emergency, right? It was a pandemic. And so there were areas around the world that they so- just said, "You know, it looks like it might work." It's a safe drug. It's a very well-known drug, right? So, (clears throat) people used it. And so that, that was the first signal, was just from a cell culture model.

    2. JR

      So, it was a, it's a well-known drug.

    3. PK

      (coughs)

  4. 4:59 – 8:05

    YouTube strikes and the problem of defining “deceptive medical information”

    1. JR

      It's been in use for 40-plus years, and, uh, the issue became that discussing this and discussing what you just said on YouTube led to your channel getting now one strike on one channel and is it three strikes on your clips channel?

    2. BW

      No. We have, uh, and YouTube has behaved very bizarrely with respect to our channels. They've delivered one strike to each channel, one warning to each channel, and they have removed many videos, but they've played a game with their accounting system, where they've removed multiple videos, filed them under a single warning. So, it's not clear what they are doing or why, but it is clear that they don't want certain things discussed. And, um ...

    3. JR

      What has been their explanation? We actually got an official explanation from YouTube. Maybe we should read that.Maybe we should just read what their response has been, 'cause the, the response has essentially been they, they have one, is it the CDC that they'll tolerate, or that they'll, they'll agree to listen to them? Because obviously it can't be everybody now-

    4. PK

      So-

    5. JR

      ... because we have the WHO is now saying that you shouldn't vaccinate children. They're not recommending you vaccinate children or pregnant people, right?

    6. PK

      So-

    7. JR

      Is that okay, that, but l- we, we should be clear about this, right? That's correct, right?

    8. PK

      Well, there's a number of different agencies, like you just mentioned, right?

    9. JR

      Right.

    10. PK

      In the US, um, and actually, I don't know which agency those different social media channels are basing what they're considering approved therapies or unapproved therapies.

    11. JR

      I think, I think it's the CDC. Isn't that-

    12. PK

      Well-

    13. JR

      Yes. Is that what it is, what YouTube quoted Tim as-

    14. BW

      It says, "The CDC, FDA, and other local health authorities."

    15. JR

      Right. But if you, up until recently, if you said, "I don't think children should get vaccinated," they would pull that.

    16. PK

      Right.

    17. JR

      Right?

    18. PK

      Right.

    19. JR

      But now, the WHO is saying, "We don't think children should get vaccinated." I've also seen recent recommendations that say that women, uh, that it's completely safe, if you're pregnant, to get vaccinated. The WHO does not say that. The WHO says you have to contact your care provider, which is a weird sort of way of, like, saying, "Just ask your doctor." But your doctor, theoretically at least, should not know any more than anybody else knows. Like, this is a weird... Like, when people say, "What, what are, what is the science?" Well, there's a lot of science going on here, and there's science coming from different directions. And depending upon who you listen to, you're gonna get a different set of protocols, right?

    20. PK

      There's no question. You know, the way I talk about this is that you're seeing just this inconsistent standard, especially around therapeutics. The, the, the, the drugs that they favor and the ones that they don't, really, it's very hard to follow consistent scientific principles being applied there. In fact, there seems to be other principles being applied. But what you just highlighted is this discord between guidance from major agencies are, are completely different, right? So, so now they're diverging around vaccines.

  5. 8:05 – 18:38

    Agency contradictions: remdesivir, vaccines, and airborne/aerosol transmission

    1. JR

      What is the divergence? Could you explain to us-

    2. PK

      So-

    3. JR

      ... what-

    4. PK

      So diverge meaning, so the WHO tells us-

    5. JR

      No, I mean, but what is the, what's the specific, uh, divergence?

    6. PK

      In, in other examples?

    7. JR

      Yeah, like what-

    8. PK

      So number one, remdesivir.

    9. JR

      Okay.

    10. PK

      $3,000, uh, uh, dose drug, right? WHO does not recommend in the hospitalized patient. In the US, every single hospitalized patient gets remdesivir. That would be-

    11. JR

      Why, but why is that?

    12. PK

      That's what I'm just saying. It's an inconsistent application of the science, so-

    13. JR

      Right, but why, why are they giving them rem- remdesivir? Is it based on any studies?

    14. PK

      Oh, it's, it's an- Well, it's, yes, there are studies. So there are studies showing some support, but it doesn't show really what we would call important patient center outcomes. So yes, it could get you out of the hospital a little bit sooner. There is some signal that it might actually reduce mortality, so it might save some lives. But it, its impact is actually minimal, and the, the studies vary. And so the WHO does not recommend it. They did a big trial of remdesivir. They showed it did not help anyone, and so they don't recommend it.

    15. JR

      And is remdesivir something that's patented, uh, on the-

    16. PK

      Oh, yeah.

    17. JR

      The thing about, one of the things about ivermectin is it's been around so long that there's a generic version of it available.

    18. PK

      Yep.

    19. JR

      Is that correct?

    20. PK

      That's a key feature of ivermectin.

    21. JR

      Okay.

    22. PK

      There's no money to be made off ivermectin.

    23. JR

      And no one can kinda control it. It's not, it's not like e- any pharmaceutical company can manufacture-

    24. BW

      It's out of patent and-

    25. JR

      Right.

    26. BW

      ... not, not high profit.

    27. JR

      This becomes part of the issue with highlighting it, right? 'Cause-

    28. BW

      So I, I think we probably need to put a bunch of things o- on the table.

    29. JR

      Okay.

    30. BW

      Otherwise, we're gonna end up very-

  6. 18:38 – 29:28

    Lab-leak narrative reversal and the broader theme: misinformation vs disinformation

    1. JR

      And this problem that we're highlighting here is that all this stuff is developing over the course of this pandemic and the rules are changing and the, the agreed upon facts are changing.In the beginning of the pandemic, if you just go back seven, eight months ago, if you said that it leaked from a lab, you get lumped instantaneously into a conspiracy theorist and a Trump supporter. And you get dismissed, and you get, you get censored from Facebook and you get censored from YouTube. Right? This is all, we all agree upon this. That's not the case anymore. Now, because of a lot of people's work, uh, because there's, there's a lot of people that have stuck their neck out and risked being labeled as a conspiracy theorist or as a Trump supporter, just to point out the science. And now, the consensus is it's very possible that it leaked, if not likely, that it leaked from a, from a lab. In fact, this Jon Stewart clip that's been going around-

    2. PK

      Mm-hmm.

    3. JR

      ... is, it's hilarious to watch Stephen Colbert panic and try to, try to dismiss what he's saying or try to pretend that it doesn't make any sense, interrupting a comedy bit on a comedy show. And this is how strong the narrative is at a corporate level, because he's on this big time television show, so there's, you know, it's, you're, you're on a network. Y- there's probably a lot of pressure to stick with the conformed narrative, and Jon Stewart literally is in the middle of a comedy bit, and Colbert's trying to handicap it. He's trying to hamstring the comedy bit because he doesn't want him to continue saying what he's saying, and to say it in a, in a comedic way is actually even worse, 'cause it's actually funny-

    4. PK

      Right.

    5. JR

      ... how stupid it is to dismiss instantaneously that it came from a lab when it literally is the same exact disease they work on in the lab that's in that city, and three people from that fucking lab got sick in 2019 with the exact same symptoms that you're seeing. And one, one of their spouses died from the exact same symptoms. Right? Is that all safe to say?

    6. PK

      I think, I think ... Um, I don't know about the particular story on the, at the end of what you just said, but-

    7. JR

      I think it's pretty ... Th- th- the, please Google that because, um, in 2019, in November of 2019, three workers from the Wuhan Institute, this is all from memory, came up sick and they were hospitalized with the exact same symptoms that you're seeing from COVID-19 patients.

    8. PK

      Yes. No, you-

    9. JR

      And I believe one of their spouses died.

    10. PK

      I do not know about the spouse having died. I think I just didn't read it carefully enough.

    11. JR

      Well, I might be wrong.

    12. PK

      But you're right about the three, the three workers-

    13. JR

      Yeah.

    14. PK

      ... and the, and the belief that this happened. But let me just say-

    15. JR

      But my point is that this keeps evolving and this keeps, this ... So to like, to stop conversations, it's very dangerous because you, you might be censoring something that's absolutely 100% true. So there's people that would have gotten that information and it would've educated them and, and expanded their understanding of it. US Intel reports identified three Wuhan lab researchers who fell ill November, 2019. Um, s- p- look at this, but, but the evidence is far from conclusive. Like, why'd you put that in there?

    16. PK

      Right.

    17. GK

      Insufficient evidence. So-

    18. JR

      But isn't this funny the way they wrote that? But see if you find the thing there.

    19. GK

      Correct.

    20. JR

      I just wanna be clear-

    21. GK

      Can I make one-

    22. JR

      ... if it's about the, if the spouse died. Just ...

    23. PK

      I wanna make one point-

    24. JR

      Okay.

    25. PK

      ... also that, you know, when you talk about ... Yeah, so you bring up this point about the Wuhan lab leak and how that was discredited, right? Uh, not enough evidence and, and basically, you had that discussion suppressed. I wanna bring that into the larger context, which for me, that's an example of what's called disinformation. So when the science runs counter to the interests of whoever it is, a political body, a, a somewhat large financial interest, what they do to counteract inconvenient science is they employ tactics of disinformation. So I wanna be clear that misinformation is what I'm being accused of, (laughs) which is I'm a medical misinformationist, because I'm providing information that is not supported by the establishment, right? So anything that doesn't agree with them is misinformation, but what they do is disinformation. So the science around the lab leak was inconvenient to a lot of people. And so that was distorted, suppressed and debunked, right? But now we're finding out that if you really do look at the science, the truth is a little different. I'm gonna say that's very similar to the ivermectin story. The science around ivermectin is up against one of the largest and most powerful disinformation campaigns, I think almost ever. And-

    26. JR

      And we should be real clear that you were one of the very first people to point out that the characteristics of the virus seemed to indicate upon closer examination that it was engineered. You were one of the very first, you did it on my show, and we both got labeled again as conspiracy theorists and leaning or dog whistling to the right or whatever.

    27. PK

      And so, uh, the molecular work was done by, uh, or the investigation into it was done by Yuri Deigin, who I had on my show.

    28. JR

      (laughs)

    29. PK

      I came on your show and talked about it. And yes, we were both, uh, dismissed as dist- as, uh, trafficking in conspiracy theories. It's a tell when they use that term.

    30. JR

      And this was about somewhere around like April of last year. Correct?

  7. 29:28 – 40:48

    How “real” scientific consensus forms vs. top-down consensus enforced by platforms

    1. BW

      So I wanna- I wanna put some, uh, context here.

    2. JR

      Okay.

    3. BW

      Heather and I are doing two things which I think work and do mean that it is the- I- I don't want YouTube censoring anybody, frankly. I don't think the censors are ever right. But, um, what we are doing is we are showing our work, and when we get something wrong, we are dedicated to going back-

    4. JR

      Yes.

    5. BW

      ... and correcting it so that people who are trying to track our model of things get the update, right?

    6. JR

      Yes.

    7. BW

      And that is the right way to do this work. Now, what is happening in officialdom is the opposite, and the key thing to track is this word consensus, right? Scientific consensus is two almost opposite things in this case. Scientific consensus, a normal scientific consensus looks like, you know, plate tectonics, right? Plate tectonics was an absolutely heretical idea when it was introduced. The idea that the continents are moving, wow. That was mind-bluing- blowing, and almost nobody got it at first, right? Today, everybody gets it. We all understand the continents move and we understand how, right? We know about subduction zones and these things, and we've got a model that makes it make sense. And you could present something that would challenge plate tectonics. You could do that. But, you know, you've got an uphill struggle because we have arrived at this through a lot of study, right? And the evidence is really strong. And so there is a consensus about it. Consensus that shows up like that (snaps fingers) in the middle of an emerging-

    8. JR

      Mm-hmm.

    9. BW

      ... pandemic, right, where you've got a brand new pathogen which we know very little about... Uh, I remember going out of the house wearing sacrificial gloves, cotton gloves, that I knew I could touch things and then when I got home, I could throw them away or I could wash them, right?I stopped doing that almost instantly as it became clear that actually, although many viruses do transmit from service- surfaces, this one doesn't. Right? It's not to say it can't happen ever, but almost never. Right? That's not its mode of transmission.

    10. JR

      Correct.

    11. BW

      So the point is, the consensus arises from the work, from people challenging each other and discovering that, yeah, that thing seemed to make sense, but it doesn't add up when you look at the evidence. Right? That's how the consensus happens. These consensus, these consenses that we are being handed about how this virus works, what works to fight it, what doesn't work to fight it, what you should do in order to protect yourself, these things are being handed down from on high. And then they are silencing the people who are saying, "Hey, wait a minute. That thing you just told me from on high doesn't square with all the stuff I can see." Right? So they are shutting down the challenge to a consensus that has no right to be labeled as scientific because it isn't. It didn't arise through the normal process. It isn't what most people think. It is, it is an official position. Right? That is not a scientific consensus. And the lab leak is the perfect example of this because behind the scenes, a lot of people understood that the story they were being told wasn't right, that there was something very conspicuous about the coincidence of this virus emerging in Wuhan on the doorstep of the Wuhan Institute of Virology. Lots of people understood that. Very few were willing to say it in public. And so that leads me to the thing that I think you need to track, which is you've got a bunch of heretics who are saying things about ivermectin, about the hazards of vaccines, about all of these topics. Who do you believe? Are you gonna believe the heretics? Well, the heretics actually are an interesting group, and the thing that unites them seems to be their independence of the structures-

    12. JR

      Yeah.

    13. BW

      ... that are controlling others. Right?

    14. JR

      Mm-hmm.

    15. BW

      So what, what do you make of it when the people who are free, who don't have to answer to their department chair, right, are saying one thing, and the people who are signed up for some system that holds their well-being in its hands are saying the other thing, right? And in this case, YouTube is playing this weird role, right? I'm free. I can talk about scientific evidence. But in order to talk about it with my audience-

    16. JR

      (coughs)

    17. BW

      ... I have to go through YouTube, right? So YouTube is playing like it's my department chair and it wants me to shut up about certain topics, and it's going to turn up the heat on me until I do, which I won't. But nonetheless, that's the point, is something would like to limit the discussion so that we are all on the same page on topics where we couldn't possibly all be on the same page.

    18. JR

      Not only that, they're trying to limit the discussion when if you watch your videos and you listen to either Heather, yourself, or Dr. Kory or any of these other guests that you've had, all you are going to see is rational discussion of the facts, and the facts presented with real data. And when you censor that, we have a real problem, and it's never good. And there's this weird sort of dismissive, uh, air that people have about these things. This, the, the propaganda in this regard has been so effective. Um, I was having a conversation with someone the other day, and they were discussing different treatments and how videos are being pulled, uh, and how, and they brought up ivermectin, and this other person that was with them said, "Good, because, you know, there's too much bad information out there. They should pull that stuff." And he had to explain, "No, this is actually ivermectin. There actually is some evidence to support its use, and it could be extremely beneficial to people, particularly in early stages of the disease." And the only way we're gonna know about this is if it gets discussed, if more doctors hear about this, more people hear about this, more studies emerge, and then that may become the new consensus if we're allowed to look at the facts. Not we, but you guys are allowed to look at the facts and discuss them openly. If you're not, we have a real problem because now we're relying only on the organizations that have already shown that sometimes they're wrong.

    19. BW

      Yeah.

    20. JR

      So if that's the only way we get our information, we, we may be wrong, and lives are in danger if we're wrong.

    21. BW

      Oh, absolutely.

    22. JR

      I wanna, I wanna-

    23. BW

      We will lose lives if we cannot sort out where... I mean, even if those agencies were perfectly immune to capture, we have to be able to figure out where they've got it wrong so that they can get smarter, right?

    24. JR

      Yeah.

    25. BW

      (clears throat)

    26. JR

      And the more intelligent people that understand the data, looking at it and discussing it openly, the better for everybody. Again-

    27. BW

      Absolutely.

    28. JR

      ... we're, when we're talking about you guys-

    29. BW

      Yeah.

    30. JR

      ... we're not talking about crazy conspiracy theorists that are discussing hollow Earth. We're t- we're talking about some real stuff.

  8. 40:48 – 57:48

    Ivermectin evidence basics: RCTs, meta-analyses, and what critics are (and aren’t) saying

    1. BW

      We push back on each other. We don't pretend to all agree to the same stuff. Okay to the, to the question you asked me though. Things that have emerged of late. So first of all, we should talk about the evidence on ivermectin and we need to be careful, right? The evidence on ivermectin is a vast landscape. There's lots of evidence on its effectiveness with respect to SARS-CoV-2 and the evidence is noisy, right? There is clear signal within it. One of the things that is absolutely maddening about trying to talk about that evidence is that the response is A, incoherent. The response pretends that there is no evidence that it works rather than a noisy data set in which it generally does appear to work, but the degree to which it works and in what way it should be administered, there's variation around that. So we, we, there's this, this monolith that says that we don't have the evidence and what we need is large scale randomized controlled trials. And in a sense this is, uh, this is an obvious tell, right? Randomized control trials are good if you've got them. There are quite a number of randomized control trials with respect to ivermectin. They may not be as large as you want, but in general, very large trials are necessary when you're looking for very small effects, right? What we do have is or several meta-analyses, a meta-analysis is an analysis that takes a bunch of different studies that were done and figures out how to pool the data from them to look for a signal. It makes a big study out of little ones and it has a huge advantage to it, right? You can do a large study and let's say that you got the dosage 50% what you needed to in order for it to be effective, right? That large study would say Molecule X does not show any evidence of being effective against Disease Y because you got the dosage wrong, right?

    2. JR

      Mm-hmm.

    3. BW

      It's not evidence that the molecule doesn't work, it's evidence that something about that protocol with that molecule didn't work. Whereas if you take, if you do a meta-analysis and you group together a lot of little studies, then you will have some bad studies that will fail to show an effect and you'll have other studies that will get it closer to right end. So the net effect of all of them tells you what direction to go. And in this case, we have meta-analyses and they're very clear. This molecule, which we've seen work in vitro, that is to say in the lab, in culture, also is effective in patients and it's effective in two different ways, right? This is Dr. Kory's area of expertise, but let me just say I want to divide ivermectin into two things so that we're always clear what we're talking about.Let's say ivermectin A is prophylactic ivermectin. You take it to prevent getting the disease. Right? Ivermectin-

    4. PK

      And this is an ... It's an anti-parasitic drug?

    5. BW

      It was discovered, uh, in Japan by Satoshi Omura, um, who got a Nobel Prize for it with William Campbell, a Merck scientist. I- the Nobel Prize was awarded in 2015, but it was discovered in 19-

    6. PK

      70s. Yeah. I mean, the first, the first organism was in the '70s and the, the molecule was purified in late '70s, early '80s.

    7. BW

      Yeah. This molecule has cured, uh, river blindness and elephantitis, two very devastating diseases. It's regarded by the WHO as an essential medicine, safe for children. Um, it has been administered four billion times. Uh, it's a highly effective, safe drug for these parasites. And so, this, the thing that was mentioned earlier where it was found in cell culture to work, there was this desire at the beginning of COVID to figure out, well, what molecules are effective?

    8. PK

      Yeah.

    9. BW

      Where might we look for a dug- drug that would work? And so they, you know, basically they weren't looking for protocol. They were just throwing a bunch of molecules at the disease to see which things showed some sign of usefulness. And from there, we get to all of these studies, which when compiled in a meta-analysis tell a very clear story.

    10. PK

      Let me add a couple of things to this cool story about ...

    11. BW

      Please.

    12. PK

      So, ivermectin already won the, the Nobel Prize for the discoveries 'cause it literally transformed the health status of huge portions of the globe in eradicating parasitic diseases. The one called river blindness is ... It's a really moving story because you had populations, villages in Africa where men, by the time you were 40, you were blind. And so you had like, these communities where the children would lead the elders around like, with a stick because they were all blind from this parasite.

    13. BW

      (laughs) .

    14. PK

      And so basically, this drug restored the sight and transformed the lives of millions of people around the world. And so I- I find that a really moving story, just its history in terms of parasites. And now, and then Brett brought up viruses. You know, that study that we already talked about in Australia, that study actually comes on 10 years of studies in the lab on other viruses. So, it's been shown to be effective against Zika, dengue, West Nile, HIV, even influenza. Again, all lab studies. Uh, we don't really have clinical trials in the other viruses. Um, but when this pandemic came, it wasn't really a crapshoot to try out ivermectin in an RNA virus. And so, um, it already-

    15. BW

      I didn't realize that.

    16. PK

      Yeah.

    17. BW

      I can say that.

    18. PK

      It already has 10, 10 years of, of-

    19. BW

      Learning this from you now.

    20. PK

      ... antiviral effects in the lab. So, in fact, I'm gonna foreshadow a little bit. It's my secret belief that as we go into the future, 10, 20 years, my hope and what I guess is that it actually will prove to be a really broad antiviral against other viruses. And so, I'm like, really optimistic about the future of this molecule on other viruses. We can talk about COVID (laughs) still 'cause, you know, the, the data that, that Brett brought up is, is, um ... It, it, in my mind it's profound. And I think Brett's being very cautious, which is correct. But as a guy who's been immersed in this data, who's been living with it, who's a physician who's been using it. I mean, I've been using it for eight months. I am part of a network of physicians around the world that I talk to re-, uh, you know, regularly, many of whom have treated in the hundreds to thousands of patients. Um, w- we know how effective it is. And so, um, you know, I, I have, I have pretty strong opinions on this data. But the points that Brett brings up is very true. It's ... You know, this, this obsession with this large randomized control trial is, um ... (sighs) it's fraught with error when you do that. It's not appropriate for a pandemic. And it's also a tool that's being used as a disinformation tactic. So, some of it is scientifically based. We all like big randomized control trials when you can get them, even though they, they're prone to error. Um, but what I try to remind the world is that when you look at the strength of medical evidence to prove something in medicine, you start at the bottom, which is an anecdote, right? So, let's say you got sick, Joe, and I gave you ivermectin and the next day you felt better, and I'd say, "I found the cure for COVID." That's not strong evidence, right? (laughs) Especially with a virus. People get better without it, right? So, you have anecdotes, case series, right? Then you have like observational trials where you just follow a group of patients or you look at a group that you treated versus who you didn't, maybe retrospectively. And it's called this pyramid of medical evidence. The top of that pyramid is not a large randomized control trial. It's actually what Brett said. It's a meta-analysis of randomized control trials. The reason why, because any individual trial can have an error or a flaw or a dosing or a timing problem, it might lead you to the wrong conclusion. But if you have a whole collection of trials and then you put them all together and you look for the signal out of that, it's much more robust 'cause it corrects for any individual flaws that you'll see in studies. And so when we talk about that there are meta-analyses of randomized control trials, 24 randomized control trials, thousands of patients, that's fairly unassailable evidence to show massive impact of this drug against COVID. Are there any credible critics of these conclusions? Are there any-

    21. BW

      (clears throat)

    22. PK

      ... uh, very interesting criticisms of the use of ivermectin?

    23. BW

      Uh, I want to, I want to-

    24. PK

      Please.

    25. BW

      ... say something. Y- there, there is room for skepticism on ivermectin. But it does not explain the behavior of the skeptics. Right? In other words, if we look at the standard of evidence that they appear to be applying here, I don't think it's defensible in the end, but reasonable people could potentially disagree. The problem is when you've got a drug that's this safe-... that does appear to work in many of the studies that have looked at it, and you're not giving it to patients who show up and, uh, test positive for COVID, even when you know that for viral disease- diseases treating them early is the key to helping them, that doesn't add up. Because if, you know, the Hippocratic Oath in this case would suggest that the safest thing to do is to give the drug, and if it doesn't work, you haven't harmed them. But if you fail to give it to them and it would've worked, you have. So I would just point out, the strange obsession with large randomized controlled trials is actually cryptically an attack on several things. If you're going to insist that that is the only kind of evidence you will accept before prescribing this drug, you're signing up for new expensive drugs over cheap repurposed ones. You're signing up for unknown risks over known ones. We know 40 years of history on this ivermectin for example. You're signing up for shareholders over patients, 'cause these large-scale trials are very expensive and the drug companies have to pay for them. So you're basically saying any drug that's out of patent, and therefore nobody is going to, uh, you know, lobby for it, isn't going to be able to find the money to do the trials. And you're signing up for effectively phase three information over phase four. Now phase four is an informal designation for the phase after a drug comes to market, right? The point is you don't really know how dangerous something is until you've seen it in a large population that has lots of variation in it and has enough time for problems to develop, right? That's phase four. But what we've done is we've effectively suspended a lot of the rules of evidence for things like vaccines that were brought to, uh, market under emergency use authorizations, and then we're setting a stupidly high standard for things that are very safe and appear to work. And I would just say by analogy, what's the best kind of evidence for a crime? Right? I would say video evidence of people committing the crime, right? Video evidence in which you get a clear sense of who the person who's committing the crime is. Okay? Let's all agree that that's the best evidence. What if we said that's the only evidence we're going to accept because we have really high evidentiary standards, right? There's no crime if it didn't get recorded on video where you can see the person's face.

    26. PK

      Right. Good analogy.

    27. BW

      Okay? Well then the point is, all right, now effectively lots of stuff that we would like to make illegal isn't illegal because all you got to do is make sure there's no camera around and you can do it. That's what they're effectively doing here, right? By insisting on that standard and ignoring all of the very high quality evidence that has come in some other form, they are effectively setting a bar so high that it can't be met. And why they're doing it, we can speculate about, but the fact that it makes no logical sense is transparent.

    28. PK

      Well, let's speculate.

    29. BW

      All right.

    30. PK

      'Cause this is part of some of the things that I was discussing earlier when I said things that are coming to light. New information that we know over the last few weeks.

  9. 57:48 – 1:11:21

    Prophylaxis claim: prevention rates, dosing nuances, and the “end the pandemic” argument

    1. BW

      All right. Couple things. Um, one, Jamie, can you put the abstract of that paper back up? Because there's this thing. So the world is very focused on using ivermectin to treat COVID, which I understand, but we miss this other thing. So scroll down a little bit. Therapeutic advances. There it is. Sentence in the middle. Okay? This might be one of the most important sentences written this century. "Low certainty evidence found that ivermectin prophylactus, prophylaxis reduced COVID-19 infection by an average of 86%, 95% confidence interval between 79% and 91%." So, that sentence actually is a hallelujah sentence, because what it means is even if ivermectin were completely ineffective at treating people who have COVID, that number is high enough because it is over the number, uh, that we understand herd immunity to be for this disease, i- i- any number that has been proposed, uh, as far as I know. Because that number is so high, what it means is that ivermectin alone, if properly utilized, is capable of driving this pathogen to extinction.

    2. JR

      And we should discuss what the, what the word prophylaxis means, 'cause ma- many people may not know. They think about it as a condom.

    3. BW

      Right.

    4. PK

      So Joe, Joe, (laughs) I've been told multiple times when I talk about ivermectin to use, um-

    5. JR

      Preventatively.

    6. PK

      ... preventatively. Yeah.

    7. JR

      Yeah.

    8. PK

      Because (laughs) you're absolutely right.

    9. JR

      Yeah.

    10. PK

      A lot of people don't understand the context.

    11. JR

      But all, all it means is to take the drug-

    12. PK

      (clears throat)

    13. JR

      ... to anticipate that you may get it, so if you're in a high-risk area, you take it and it's, it'll p- protect you-

    14. BW

      Yeah.

    15. JR

      ... from infection.

    16. BW

      Prevent, prevent you from contracting it. So I should say-

    17. JR

      Yeah.

    18. BW

      ... uh, I was a little, uh, I was very encouraged by that number. That number-

    19. JR

      Crazy number.

    20. BW

      ... is high enough to be, uh, independently the end of COVID if we decide to make it so. I was concerned at the beginning of that sentence starts with low certainty evidence.

    21. PK

      Mm-hmm.

    22. BW

      So I contacted Tess Lory and I asked her what that meant, and it turns out it's part of a categorization scheme within the data science that is used to do these meta-analyses. And low certainty means that there is an expectation that if you had more information, the number would move a little bit. It doesn't mean that it's uncertain whether the effect is there.

    23. JR

      Correct.

    24. BW

      It means that-

    25. JR

      Correct.

    26. BW

      ... that the, identifying the exact number is liable to be sensitive to more information. But nonetheless, again, this is the issue of ivermectin A is prophylaxis. Ivermectin B is treatment. The evidence that it is highly effective as treatment is, I would argue, overwhelming. You can see it in this meta-analysis. The signal is very clear, and my experience has been when you look at the papers in which it's disappointing, you very frequently see a reason, right? In general, they treat late. We know that that is an obstacle to it working. Um, the last paper I went to gave it on an empty stomach. This is one of these things where, you tell me if I'm wrong, Pierre, but uh, if you're treating parasites, you may want to keep the drug in your gut, and therefore you don't want it to dissolve and cross into your blood. If you're treating or preventing COVID, you do want it to cross into your blood, and the fact is the molecule is fat-soluble. So if you're taking it as prophylaxis, you should take it with fat, but they don't like to do stuff like that in these trials because empty stomach is the way to get all of the patients to be the same. If they've eaten something, they will have, will have eaten different things-

    27. JR

      Right.

    28. BW

      ... and it creates noise. So anyway, there's a, there's a bias there in some studies in which they block the effect in part by not letting it cross into the bloodstream.

    29. PK

      Yeah. Two, two more points on this abstract. Um, so the two most important words, right? So, so Brett emphasized this finding of...... 86% protection against infection, uh, if you take it preventatively, right? And that low certainty evidence means it could be higher than 86% (laughs) protection, it could be lower. Um, I maintain, and I want to really emphasize this, is that if you look at the trials that make up those preventative trials, right, the ones where you take it weekly, 'cause they had some which you took weekly, some where you actually just took it once a month, and these, they, uh, they actually had profound, uh, uh, benefits. But the ones that you took weekly led to, like, near perfect protection, like 100% protection in a large, uh, population of healthcare workers. Now, in that trial, they also took it with, um, like a seaweed called carrageenan, and it's more common in South America. It's, it's considered to be virucidal, it's been shown to be virucidal. And so, they sprayed that and their-

    30. JR

      Virucidal?

  10. 1:11:21 – 1:22:23

    Follow-the-money hypothesis: patents, EUAs, Merck’s reversal, and the $3B antiviral push

    1. BW

      Can we... can we get the New York Times piece up? The Carl Zimmer piece?

    2. JR

      Yeah.

    3. BW

      So, uh, I've been wondering about this for the longest time. There is obvious resistance to looking at the evidence, which is clear enough. Why would they be re-... and I should point out, there's another interesting piece of evidence which is not only was the safety of ivermectin challenged by the CDC, was it?

    4. PK

      Uh, well the WHO-

    5. BW

      The WHO.

    6. PK

      ... kind of suggested that it may not be safe.

    7. BW

      But Merck itself, Merck, which was the manufacturer of this drug, Merck, which has given away millions of doses, uh, in Africa, attacked the safety of its own drug.

    8. PK

      Sure.

    9. BW

      Said that it wasn't safe and shouldn't be used in this case, which was strange. But then here, last-

    10. PK

      Crazy.

    11. BW

      It's crazy.

    12. JR

      Has that ever happened before?

    13. BW

      Well, th- here's the thing. I was waiting w- you know, what don't we know? And there are a certain number... I mean I... you know, I don't know how much this is a Merck-centric phenomenon, but there are a couple things about, um, Merck. Merck has announced that it has a new drug that it's very excited about for COVID and it's molnupiravir?

    14. PK

      Molnupiravir, Brett.

    15. BW

      Molnupiravir.

    16. PK

      Rolls off the tongue.

    17. BW

      All right, so this is, uh-

    18. JR

      So this is the article?

    19. BW

      This is the article. Scroll... Uh, let's see. I, I wanna... there's some paragraphs here. Uh, go back up. Back up. There's a paragraph about, uh, what happened when they looked for drugs that would be effective against COVID. So this is Carl Zimmer. This is one of the world's premier science writers writing in the New York Times. Back up more.

    20. JR

      That's the top.

    21. BW

      Oh, that's the top?

    22. JR

      Wanna talk about the three-

    23. BW

      It's gonna be about th-

    24. JR

      ... the three billion, uh, Brett? You wanna talk about that?

    25. BW

      Well, we're gonna get to the three billion here in a second, but keep going. Stop. Uh, "At the start of the pandemic, researchers began testing existing antiviral, virals in hospital... hospitalized patients with severe COVID-19. But many of those trials failed to show any benefit from the antivir- uh, antivirals. In hindsight, the choice to work in hospitals was a mistake." Um, okay, go down a little bit. Uh, down a little bit more. Stop. Uh, "So far only one antiviral has demonstrated a clear benefit to people in hospitals, remdesivir." That's the $3,000 a dose drug that, uh, is authorized. "Originally investigated as a potential cure for Ebola. The drug seems to shorten the course of COVID-19 when given intravenously in patients. In October, it became the first and so far the only antiviral drug to gain FDA approval to treat the disease. Yet remdesivir's performance has left many researchers underwhelmed." Um-

    26. PK

      ... weak.

    27. BW

      Yeah. I'm missing the, there's a paragraph in here where he says that the search for drugs that work didn't turn anything up. In any case, people can find it on their own, I guess. But this is-

    28. PK

      (coughs)

    29. BW

      ... this news report came just before Anthony Fauci ... Sorry, my glasses do not interface well. Uh, before, uh, An- Anthony Fauci gave a press conference about a three billion dollar initiative to find drugs that work against COVID. Now, of course, these drugs that they find will all be under patent, and therefore, highly profitable. So, what you've got is, uh, drug companies. Merck is involved in molnupiravir, this new drug. Uh, it is also involved in an agreement with Johnson & Johnson to distribute their vaccine. And strangely, we are ignoring the evidence that is right in front of us, that we have multiple drugs that are highly effective for COVID. And one, that I would point out again, is highly effective as a prophylactic. So, I don't know anything about the business side of this. I do know what fiduciary responsibility is. I know that the shareholder value must be driving things behind the scenes. I know that these companies have been immunized from liability with respect to harms that might be done by the vaccines that they're distributing. So, there's a question about do all of those things add up to explain the many anomalies about the recommendations of how to treat patients, uh, who have COVID? And-

    30. PK

      I believe they do. (laughs)

  11. 1:22:23 – 2:06:09

    Real-world rollouts: Mexico’s test-and-treat, Argentina/La Pampa, India, and variant claims

    1. PK

      around their favored medicines, like remdesivir, they kind of do funny stuff with the trials. They change endpoints. They use weak outcomes, like, okay, two days less of a hospitalization for $3,000 doesn't save lives, doesn't reduce mechanical ventilation, when you have other drugs that do. But another absurdity is Mexico. Mexico, out of all of the countries that we just talked about, they did something that I think is unique, historic, and needs to be recognized. So, what happened in Mexico is they have, uh, an agency called the IMSS. It's basically their social security department which covers a large part of the healthcare system, and they had, they went rogue in Mexico back in December at a time when hospitals were full. They were getting inundated. They were, they were almost like at that crisis peak like we were in, in this country around December and January. Remember when like LA was running out of oxygen, and like, uh, like India was last month? So, Mexico was in terrible condition back in December. The IMSS, and I would say, I would like that our paper and our advocacy was part of what made them pay attention to ivermectin, they implemented a nationwide test-and-treat program. Every outpatient testing center, if you tested positive, you were offered ivermectin. And you got two days, you got 12 milligrams, which is not a high dose. In fact, I consider that to be somewhat of an undertreatment. But what happened within two weeks of that, hospitalization rates plummeted, death rates plummeted. And over the next three months, they had basically rid COVID, opened bars, opened restaurants at a time when the vaccination rate was like 1% to 5%. So, it wasn't the vaccines. It was all related to this. And then three weeks ago, maybe it's three weeks now, that agency put out their paper, their paper, looking at the data of their program. And you know what they reported is that in many thousands of patients, those that accepted the medicine and took it, their rate of hospitalization was up to 75% lower than those who didn't.

Episode duration: 2:54:50

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