Covid-19 News

    Quote from Shane D.

    https://www.zerohedge.com/covi…abandoning-pcr-test-covid


    A bit political at the end, but until then a well sourced, good history of the COVID PCR test cycle threshold (Ct), and: "how PCR Tests have misled officials worldwide into insanely authoritative reactions".


    Along the same lines, I noticed the other day in an article someone posted here, that Israel was still using a 37 Ct.

    Sorry Shane - you are way out of your depth here.


    You should not be reading this stuff. It is bad for your brain. Look at the name on the site. Look at the way its "scientiific" information is written.


    Yes - got it in one - it is propagating false anti-vax memes. It is one of the famous anti-vax super-spreaders.


    From wikipedia


    Zero Hedge (or ZeroHedge)[b] is a far-right[12] libertarian[17] financial blog,[13][14] presenting staff-written articles and aggregating news and opinions from external sources.[18] Zero Hedge, per its motto,[a] is bearish in its investment outlook and analysis, often deriving from its adherence to the Austrian School of economics and credit cycles.[22] While often labeled as a financial permabear,[23][24] Zero Hedge has also been described as a source of "cutting-edge news, rumors and gossip in the financial industry".[25]

    Over time, Zero Hedge expanded into non-financial analysis,[c] including conspiracy theories and fringe rhetoric[27] associated with the US radical right,[14][28] the alt-right,[29][30][31] and a pro-Russian bias.[1][32][33][34] Zero Hedge's non-financial commentary has led to a number of site bans by various global social media platforms, although its 2019 Facebook ban[35][36] and 2020 Twitter ban were later reversed.[14][37]

    Zero Hedge in-house content is posted under the pseudonym "Tyler Durden"; the founder and main editor was identified as Daniel Ivandjiiski.[26]


    The science of PCR


    (1) PCR tests are typically very accurate. They have a high false-negative rate if swabs are not taken correctly (it is unpleasant - they need to go deep into throat and nose). However with delta it will matter less: it has 1000X more viral load trypically.


    (2) The cycle number (how much you amplify the RNA) alters sensitivity.


    (3) Delta typically has muhc higher viral load in nose and mouth, so nthere is a case for moving to a lower cycle count


    (4) Asymptomatic infections can transmit COVID (esp delta)


    (5) whether you make your case count include asymptomatics is a judgement call. Only zerohedge would see this as a political big deal. it depends whether it is overall worth having more mildly ill or even asymptomatic people self-isolate - or less.


    All this is written up by zerohedge zerofact as though CDC change or no change in guidelines is a matter of distorting science. It is not. It is just do you want the marginal cases to self-isolate or not. Not an easy decision to make, because delta alters infectivity and we are not entirely sure how much.


    Of coiurse CDC may indeed want case counts to look higher (and closer to the real infection counts) if that persuades more of the waverers to get vaccinated. that woiuld be saving lives. A good thing for everyone to do - though antivax campaigners do not seem to see this or act on it themselves.


    Shane - why is this bad judgement? You should know a conspiracy theory when you read one (the coloured text rather gives it away).

    Quote from Shane D.

    I noticed the other day in an article someone posted here, that Israel was still using a 37 Ct.

    Case counts have never been accurate - which is why care is needed in interpreting them.


    If Israel counts more asymptomatics than most other countries it of course makes sense of the relatively higher "breakdown infection" rates there.


    It is however not a conspiracy, nor does it matter much in terms of a PR war. It makes some things look better, some worse. For those who unwisely pay attention to inevitably badly defined statistics.

    Quote from RobertBryant

    Me too ... but will wait for the longterm data on the adverse effects of synthetic RNA

    In what sense is this RNA "synthetic"? What does "synthetic" mean in this context? The RNA is precisely -- down to the last molecule -- the same as the natural RNA in the virus that expresses the spike protein. If it were not precisely the same, it would not work. It would not produce proteins that give rise to effective antibodies.


    So, why do you call it "synthetic"? Because it is synthesized by people? I don't see how that can be relevant, given the fact that it is the same as the natural product.

    BTW -


    What we do know is that those very marginal asymptomatic infections induce less strong immune response than vaccination or more serious infections.


    So from any point of view whether you count them as infections is a bit marginal - they are only partly effective as herd immunity.

    Quote from JedRothwell

    In what sense is this RNA "synthetic"? What does "synthetic" mean in this context? The RNA is precisely -- down to the last molecule -- the same as the natural RNA in the virus that expresses the spike protein. If it were not precisely the same, it would not work. It would not produce proteins that give rise to effective antibodies.


    So, why do you call it "synthetic"? Because it is synthesized by people? I don't see how that can be relevant, given the fact that it is the same as the natural product.

    Of course the mRNA vaccines are much safer than a COVID infection. They include much less of the RNA sequence that exists in the virus and is massively amplified throughout the whole body in a COVID infection.


    Some people just don't think.


    Back to Ct-gate


    This is an anti-vax conspiracy meme I have not seen many places. these anti-vax distortions always interest me - they typically quite a bit of ferreting around to get to the bottom of.


    C:\Users\tjwcl\Documents\Screenshots\2021-07-26 16_40_33-Frequently Asked Questions about Coronavirus (COVID-19) for Laboratories _ CDC.jpg



    And zeroSense said (linking the right-wing often false PJMedia (see wikipedia) which partially quotes NYT:


    The number of times the sample is amplified, also called the cycle threshold (Ct), is too high.

    Quote
    When the Ct value is low, it means that there was a lot of starting material (many pages with the sentence we were interested in, or many copies of the coronavirus). When the Ct value is high, it means there was little starting material, so it takes more time to have enough copies so that you can see them. The danger when seeing high Ct values (e.g. 38-40) is that the signal you are eventually getting may not be specific: to go back to Mr. Holmes, it could be amplifying a somewhat similar sentence from a different story.


    And here is someone who has actually used PCR tests


    This is the kernel of truth that COVID contrarians have jumped on. But the reality of PCR technology is much more complicated: we can’t simply set a universal Ct value beyond which we declare all tests to be negative. The Ct value is, in a way, relative. Different laboratories have set up different PCR tests to look for the coronavirus, using different probe-and-primer combinations to look for different genes in the coronavirus’ genome on different PCR machines. Unsurprisingly, when 26 Ontario laboratories that test for the coronavirus participated in a proficiency test, they saw a variability of Ct values of up to eight cycles across them when testing the same specimen. Samples that are known to be positive and negative for the coronavirus are run alongside the unknown samples, and their behaviour during the run also affects interpretation of the results.


    This is why reporting the Ct value is not recommended in Canada: on its own, it does not mean much. In a way, it’s not unlike chicken soup. Many families have their own recipe. As long as it’s been internally validated, meaning that it looks like chicken soup and tastes like chicken soup and the people eating it are happy with it, it’s a perfectly functional chicken soup. PCR tests come in many different flavours, but as long as they are validated (by using a known quantity of virus, diluting it many times and running these samples to see what Ct values they generate), they are reliable.


    They are not perfect, because no test is perfect, but they are absolutely not the futile garbage some folks on the Internet would have you believe. The pandemic saw a rise in armchair experts, people who had never stepped foot in a laboratory suddenly learning about PCR and thinking, as in true crime dramas, that they had cracked the case wide open. But the interpretation of PCR tests for the coronavirus relies on a lot more than a single Ct value: it depends on all of the above “chicken soup” variability, plus the type of specimen collected, whether or not samples are pooled in a single well to save on reagents (with positive pools being tested individually afterwards), and on pre-test probability, meaning whether or not the person being tested has symptoms and whether or not they were potentially exposed to the virus.


    The blind reliance on Ct values unfortunately shows a misunderstanding of the complexities of molecular diagnostics. Ct values are not elementary; they require expertise to interpret.

    I predicted this 6 months ago, unfortunately I was about 3 weeks off on the UK and us rise. The UK will only see a decline over a short time while in the us the cases will level off in about 2 or 3 weeks. Around the middle of august the UK will begin seeing a sharp rise just like last year and the us will follow around the 1st of September. You might see hospitalized rise sharply to if the vaccines fail to stop infections. An early treatment during the viral stage is the only way to stop this. Unless of coarse you can immunize 6 billion people in the next month.

    • Official Post

    Are we going to keep going through this every time I link to an article from a publication you do not approve of? Yes, they are to the right, and that is why I said it was "political", but "well sourced". I look to each article, whether from the left or right, for information. If too political, with little new to learn, I stop reading and wont put it here.


    This problem with the PCR Ct settings has been reported on by both sides. Even the NYT's, Fauci, and the CDC have weighed in on it as leading to inaccurate data. Most of that is in the article I linked to.


    Once above a certain threshold (which opinions vary as to what that is), they are worse than worthless...they lead to bad decisions by the decision makers. That needs to be addressed. Was it a conspiracy as the article alludes? I don't think so. I see it more as those leaders needing good info to do best for their citizens, are not always getting it. When they don't...well that is where independent reporting comes in.


    .

    Vaccine antibody levels start to wane around 2 to 3 months.


    "Total antibody levels appear to start declining from as early as six weeks after complete vaccination and can reduce by more than 50% over 10 weeks, according to new data from UCL's Virus Watch study."


    "The findings, published as a research letter in The Lancet, include data from over 600 people and show antibody levels are substantially higher following two doses of the Pfizer vaccine than after two doses of the AZ vaccine. They are also much higher in those with prior SARS-CoV-2 infection.

    The authors highlight that although the clinical implications of waning antibody levels are not yet clear, some decline was expected and current research shows that vaccines remain effective against severe disease.

    For Pfizer, antibody levels reduced from a median of 7506 U/mL at 21–41 days, to 3320 U/mL at 70 or more days. For Astra Zeneca, antibody levels reduced from a median of 1201 U/mL at 0–20 days to 190 U/mL (67–644) at 70 or more days."

    Quote from THHuxleynew

    Those are all points worth considering.


    That was an articulated answer. I understand your position and I am not asking you to change your mind. You believe in these vaccines, they have some merits, I respect that.


    The more I read about the RNA vaccines the less I trust them. The RNA spreads into the whole body, including the brain and genital organs. It also gets encoded into your genome via reverse transcriptase. Not to mention all the well known AE like myocarditis and micro clots.


    These vaccines should have been pulled out of the market long ago.


    One point I must emphasize is corruption, here at the outset of the pandemic in France we had a respected doctor who pushed for HCQ + Zn + Azitromycine. The governement and the MSM threw everything they had at him. At the time Gilead wanted us to use Remdesivir. HCQ is extremely cheap, unlike Remdesivir. Then they banned HCQ, it became classified as "poisonous" overnight ^^ . Turned out Remdesivir was far too damaging to the body to continue using it.


    We found out lots of experts and doctors that appeared on TV were in fact paid lots of money by Gilead.


    Now as to the vaccines ( you will never find a definitive vaccine against a coronavirus, too many variants btw) ,they made a bet that the variants and the AE would be negligible, they are realizing that this is not going exactly as planned.


    The whole thing is gonna blow up, at the moment in France lots of things are unraveling, we have nurses and doctors that are starting to speak up about the covid " delta wave". It is all a big sham, they cheat on the numbers, they lie about everything and use every manipulative trick to silence you. Now they just passed a law that lets choose between taking these experimental vaccines and losing your job. 8o These people just do not care, just remember the 2008 financial crisis. Their lust for money knows no bound. Yes I know what I sound like but that is the reality.

    Quote from Fm1

    I predicted this 6 months ago, unfortunately I was about 3 weeks off on the UK and us rise. The UK will only see a decline over a short time while in the us the cases will level off in about 2 or 3 weeks. Around the middle of august the UK will begin seeing a sharp rise just like last year and the us will follow around the 1st of September. You might see hospitalized rise sharply to if the vaccines fail to stop infections. An early treatment during the viral stage is the only way to stop this. Unless of coarse you can immunize 6 billion people in the next month.

    Well, I disagree - in the sense that due to high vaccination even when UK cases were very high, UK deaths remained very low.


    You are thinking this change is seasonal. That is possible, of course, it is one of the factors. But it is not the only one so we shall see what happens. I'd predict - if I had to - everything could stay ok till schools return - so 1 week after 1 September we will maybe see problems. Not necessarily - it depends on:

    vaccine rollout

    how much has immunity decreased

    have we started booster rollout

    new more vaccine-evading variant?


    All the evidence so far is that seasonal factors are a relatively small part of the overall equation.

    Quote from Ull25

    The more I read about the RNA vaccines the less I trust them. The RNA spreads into the whole body, including the brain and genital organs. It also gets encoded into your genome via reverse transcriptase. Not to mention all the well known AE like myocarditis and micro clots.


    These vaccines should have been pulled out of the market long ago.

    I understand anyone worrying about vaccine risks. What i don't understand is why they would worry less about vaccine risks than COVID risks.


    Everything you say about the vaccine (which is a bit exagerrated if you look at the actual qtys of RNA in different organs of mice given 35X the typical human dose / weight of vaccine - they are quite extraordinarily small) is true much more for COVID:


    • COVID RNA gets everywhere - in much larger quantities than the vaccine
    • Vaccine RNA is only active 24 hours or so and then inert. COVID RNA stays affecting you for several weeks as the virus replicates (which vaccine mRNA cannot do)
    • COVID RNA includes all the tested Ok vaccine RNA + lots of other stuff not nice for you.


    I'm wondering whether this line of argument has occurred to you - it always seems powerful to me. Now that we can reckon everyone will end up getting COVID (if not vaccinated) it is a direct comparsion.


    WRT variants - my understand is that no-one expected vaccines to go on working forever against variants. And that people were quite pleasantly surprised that vaccines still work (but not as well) against delta.


    You will know that many governments have ordered booster shots. those boosters can be tweaked based on latest variants if need be, to give us another year of protection.

    Quote from Shane D.

    Are we going to keep going through this every time I link to an article from a publication you do not approve of? Yes, they are to the right, and that is why I said it was "political", but "well sourced".

    Zerohedge run conspiracy theories. That is badly sourced, no?


    in this case my point was not that the facts (a bit vague) were wrong - but that the interpretation was wrong.


    I am also not willing to say the facts are right without more data because newspapers often get these things wrong (even good ones) and in this case we have only PJmedia's partial quote of NYT who maybe did not give direct source links anyway.


    Umm...


    So the answer to your question is yes!


    :)

    Comparison of Neutralizing Antibody Titers Elicited by mRNA and Adenoviral Vector Vaccine against SARS-CoV-2 Variants


    Comparison of Neutralizing Antibody Titers Elicited by mRNA and Adenoviral Vector Vaccine against SARS-CoV-2 Variants
    The increasing prevalence of SARS-CoV-2 variants has raised concerns regarding possible decreases in vaccine efficacy. Here, neutralizing antibody titers…
    www.biorxiv.org


    Abstract

    The increasing prevalence of SARS-CoV-2 variants has raised concerns regarding possible decreases in vaccine efficacy. Here, neutralizing antibody titers elicited by mRNA-based and an adenoviral vector-based vaccine against variant pseudotyped viruses were compared. BNT162b2 and mRNA-1273-elicited antibodies showed modest neutralization resistance against Beta, Delta, Delta plus and Lambda variants whereas Ad26.COV2.S-elicited antibodies from a significant fraction of vaccinated individuals were of low neutralizing titer (IC50 <50). The data underscore the importance of surveillance for breakthrough infections that result in severe COVID-19 and suggest the benefit of a second immunization following Ad26.COV2.S to increase protection against the variants.


    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines from two vaccine platforms have been granted U.S. Food and Drug Administration (FDA) Emergency Use Authorization: mRNA-based (Pfizer and Moderna) and adenoviral vector-based (Johnson & Johnson (J&J)), all of which have been shown to be highly effective. The mRNA-based vaccines were 94-95% effective in preventing COVID-191 whereas the adenoviral vector-based J&J vaccine had 66.9% efficacy in preventing moderate to severe disease2. However, the ongoing emergence of highly transmissible variants with mutations in the spike protein raises concerns regarding possible decreases in vaccine effectiveness due to spike protein antigenic variability.


    SARS-CoV-2 variants have been classified by the World Health Organization (WHO) based on increased transmissibility and/or pathogenicity as variants of concern (VOC; Alpha (B.1.1.7), Beta (B.1.351), Gamma (B.1.1.248) and Delta (B.1.617.2) and variants of interest (VOI; Epsilon (B.1.427/B.1.429), Iota (B.1.526), and Delta plus (AY.1) and Lambda (C.37)3. The increased transmissibility and/or pathogenicity of the variants is due, at least in part, to mutations in the spike protein RBD that increase its affinity for ACE2 on target cells. Mutations in the Beta, Gamma and Delta variant spike RBDs have been shown to cause partial resistance to neutralization by the serum antibodies of vaccinated and convalescent individuals and therapeutic monoclonal antibodies4-11.


    This study compared the neutralization titers of serum antibodies from individuals immunized with three U.S. FDA Emergency use authorization vaccines (BNT162b2, mRNA-1273 and Ad26.COV2.S) against viruses with the VOC and Lambda spike proteins. The study groups were controlled for age, clinical co-morbidity, history of pre-vaccination infection and sera were collected on similar days post-vaccination. The results demonstrate a high level of cross-neutralization by antibodies elicited by BNT162b2 and mRNA-1273 on the variants but significantly decreased neutralization by those elicited by the single dose Ad26.COV2.S.


    Discussion

    Several reports have shown partial resistance of SARS-CoV-2 VOCs to vaccine-elicited antibodies4-11. The data shown here extend those findings to the Delta plus and Lambda variants. Delta plus and Lambda, VOIs, both displayed a degree of resistance to mRNA vaccine-elicited antibodies similar to that of the Beta and Delta variants. In sera collected ∼3 months post-second immunization, BNT162b2 and mRNA-1273 mRNA vaccine-elicited antibodies neutralized the variants with a modest 3-fold average decrease in titer resulting in an average IC50 of about 1:600, a titer that is greater than that of convalescent sera and likely, in combination with post-vaccination T-and B-cell memory responses, to provide durable protection. Ad26.COV2.S vaccination-elicited neutralizing antibodies showed a more pronounced decrease in neutralizing titer against the variants, raising the potential for decreased protection against the VOCs and the Lambda variant. Vaccination with Ad26.COV2.S resulted in IC50 titers against Beta, Delta, Delta plus and Lambda variants that decreased 5-7-fold, resulting in mean neutralizing antibody titers of 33, 30, 41, and 36 against viruses with the Beta, Delta, Delta plus and Lambda variant spikes, respectively, which according to mathematical modeling, could result in decreased protection against infection15. Modeling predicts that 50% protection from infection is provided by a titer that is 20% that of the mean convalescent titer. In this study, given a mean convalescent titer of 346 (Table S1), 50% protection would correspond to an IC50 of 69. The titer required to protect against severe disease was shown to be 3% that of the mean titer of convalescent sera which in this study corresponds to a titer of 10. In a published report of phase 3 trial data, a single dose of Ad26.COV2.S, 28 days post administration, provided 64.0% protection against moderate to severe disease and 81.7% against severe-critical COVID-19 in a country where 95% of circulating SARS-CoV-2 was the Beta variant2. The authors considered possible roles for non-neutralizing antibody Fc-mediated effector functions and the role of the T cell response in maintaining protection against the partially neutralizing antibody-resistant Beta variant.


    The data reported here differ somewhat from those reported by Barouch et al. and Jongeneelen et al. who found that Ad26.COV2.S-elicited antibody titers were mostly maintained against the variants16,17. In addition, Alter et al. reported a 5-fold decrease in neutralizing antibody titer against Beta and 3.3-fold decrease against the Gamma variant by the sera from Ad26.COV2.S vaccination18 which were less pronounced than those reported here. While the studies used similar assays to measure antibody neutralization and analyzed sera collected at a similar time-point post-immunization, it is possible that differences in the study populations accounted for the experimental differences.


    Several recent studies have shown that boosting a single immunization of the ChAdOx1nCoV-19 adenoviral vector vaccine with BNT162b2 resulted in high neutralizing titer against the VOCs19-21. It is likely that neutralizing antibody titers against the VOCs elicited by the single shot Ad26.COV2.S could similarly be improved by boosting with a second immunization or by a heterologous boost with one of the mRNA vaccines. While a single dose vaccination has advantages, the benefit provided by a second immunization may be well worth the inconvenience.


    The data presented here emphasize the importance of surveillance for breakthrough infections with the increased prevalence of highly transmissible variants. If an increase in breakthrough infections accompanied by severe COVID-19 is found following adenovirus vector or mRNA vaccination, this would provide a rationale for public health policy-makers and manufacturers to consider booster immunizations that would increase protection against the VOCs and Lambda variant. As such a need is not currently evident, the public health apparatus should focus on primary immunization in the U.S. and globally.

    Quote

    I’ve been fully vaccinated. What is my risk of developing long COVID if I get infected?

    The short answer is we do not know for certain yet. John Swartzberg, a UC Berkeley infectious disease expert, said no robust studies have been conducted so far to answer this question. Even anecdotal reports have been few.


    However, Swartzberg said his conjecture is that long COVID will be unlikely in fully vaccinated people. “The vaccines considerably suppress viral replication in those individuals that have breakthrough infections,” he said in an email. “Our bodies will have less to contend with during the breakthrough infection and this should make long COVID less likely.”


    He said more will be known in the next several months as COVID infections increase due to the delta variant.

    If you're fully vaccinated, what's your risk of 'long COVID' as delta variant spreads?
    The delta variant of the coronavirus is spreading quickly, with some “breakthrough...
    www.sfchronicle.com

    Quote from Ull25

    The more I read about the RNA vaccines the less I trust them. The RNA spreads into the whole body, including the brain and genital organs.

    Anything spreads into into the whole body. The mass of RNA and resulting protein from the vaccine is a million times smaller than from COVID or the common cold, so it does not spread as much. It is soon removed by the immune system.


    Quote from Ull25

    It also gets encoded into your genome via reverse transcriptase

    No, it does not. Every expert says it does not. Where did you get this bogus information? Or, if it does, so would the RNA from COVID, a cold, and every other virus.

    Quote from Ull25

    It also gets encoded into your genome via reverse transcriptase.

    UII25 - I'd like to thank you for this point - because it caused me to do some research and I found a really great detailed but followable explanation of how mRNA, saRNA, and DC mRNA vaccines work, starting with the basics of how RNA works.


    Enjoy, everyone (it has great pics too!)


    mRNA Vaccines and COVID-19 — Deplatform Disease
    A summary of mRNA vaccines
    www.deplatformdisease.com


    Another concern raised has been the idea that mRNA can somehow alter the host’s genome. That would actually be super cool and be huge for gene therapy (and I could finally give myself the giant bat wings I’ve always wanted) but this is not so. This is ordinarily impossible except if there is also a reverse transcriptase enzyme present that produces DNA from the RNA template, which is how retroviruses work. There is no such risk with any mRNA vaccine candidate. mRNA vaccines act entirely within the cytosol of the cell- they do not go near the nucleus where all the DNA is. That’s actually a major advantage of RNA-based vaccines over DNA ones.



    and some more technical detail (from the same person here (you can search for it on previous site if medium doe snot work for you):


    https://edwardnirenberg.medium…ect-your-dna-fcf05986ce9e



    • Official Post

    From a friend in Iceland...


    Iceland opened up completely 1st of July with no test for vaccinated people coming to Iceland or Icelanders who are vaccinated and returning home after trip abroad. Situation is following 600 people are now with COVID 26 days later out of them are 70% fully vaccinated so we have the biggest wave start ever now in Iceland … population 350.000.


    However 90% > 15 years are fully vaccinated In Iceland with Pfizer, Astra Zeneca Moderna and Jansen.

    So vaccines don’t stop the delta virus in Iceland so you still can get sick and spread COVID without symptoms.! But 97% of those 600 are still with mild symptoms so in a week or it will be known If you develop serious COVID or not. 50 out of the 600 have underlying risk factors.


    Iceland opened up earlier than UK with the delta virus so the news happen earlier in Iceland. Restrictions are back in Iceland until more is known after 2-3 weeks

    Quote from RobertBryant

    pseudo for a start..not in Biology101


    Calling the pseudouridine substitution "synthetic" is word-play. Pseudouridine is naturally occurring in RNA, and has no functionality different from uridine in the cytosol except to prolong mRNA stability and protect it from TLR7 & 8.


    Nevertheless - I am so glad to have this side comment - since you have introduced me to the wonderful and sinister word pseudouridylation.


    Possibly antivaxers could go around with the war cry "watch out - the government is going to pseudouridylate your RNA!. While biologically innacurate - you must admit it sounds good.

    Controversial ivermectin researcher failed to report massive conflict of interest


    Controversial ivermectin researcher failed to report massive conflict of interest
    Note that views expressed in this opinion article are the writer’s personal views and not necessarily those of TrialSite. Susanna Naggie is leading
    trialsitenews.com


    Susanna Naggie is leading a nation-wide study of ivermectin, ACTIV-6. She is also a member of the NIH panel that provided the current recommendation on the use of ivermectin in COVID-19 that is at odds with the view of leading physicians and experts in evidence-based medicine:


    “There are insufficient data for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin in the treatment of COVID-19.”


    These two positions are in conflict because a recommendation to use ivermectin in COVID-19 is implicitly a recommendation to end the ACTIV-6 trial.


    Naggie published “Developing Treatment Guidelines During a Pandemic Health Crisis: Lessons Learned From COVID-19” in Annals of Internal Medicine on June 19, 2021. Like most scientific journals, Annals requires the disclosure of potential conflicts of interest. The disclosure did not include a statement from Naggie. I posted the following comment to the Annals article on July 22:


    “62 authors of this article are listed but only 60 of the authors provided disclosures of interests. Disclosures are missing for Brenna L. Hughes and Susanna Naggie. I urge Annals to strictly enforce their disclosure policy with respect to this article and request disclosures from those authors.


    “Regardless, the following surely constitutes a conflict of interest. Both authors are employed by Duke University who received a $155 million award from the National Institutes of Health for the study of repurposed drugs in COVID-19 ( https://grants.nih.gov/grants/…-files/NOT-TR-21-024.html ). Naggie is the principal investigator on that trial. The conflict of interest arises because a recommendation from the NIH COVID-19 Treatment Guidelines for the use of one of the study drugs in COVID-19 would effectively end the trial.


    “Readers should be aware that the Guidelines recommendation on ivermectin, for example, could very well be influenced by this conflict of interest.”


    The journal did not publish the comment. However, the disclosure was updated on July 24. The updated disclosure did include a statement from Naggie but did not mention that Naggie had received ACTIV-6 grant from the NIH. I told Naggie, by email, that her disclosure was incorrect and asked if she had approved it. Her response was:


    “no this is not my correct disclosure. I had to submit several times due to some glitch with the form so I will have to resend the correct form.”


    Naggie’s conflict of interest is extraordinarily concerning. The concern is only compounded by her difficulties disclosing the conflict of interest.


    There are 49 members of the Panel but only a small group of Panel members provided the recommendation on ivermectin, in all likelihood. The NIH has avoided confirming that explicitly even under the pressure of a Freedom of Information Act lawsuit. In any case, it is possible that Naggie was responsible for the NIH recommendation on ivermectin that enabled the massive grant to her institution

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