The Hydroxychloroquine discussion is pretty bad as well.
We were confidently against Hydroxychloroquine because it was well tested in the RECOVERY trial in June 2020 [1].
The time to be optimistic was during the trial-phase of the test. Once that time passed, everything beyond that point was unnecessary and unhelpful hype.
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What's amazing to me, is that the RECOVERY trials showed that Dexamethasone cut the death rates in half [2]. Where did the Dexamethasone hype go? Why was the political discussion on the snake-oil Hydroxychloroquine?
Even months before we had a vaccine, doctors had discovered how to save roughly 10% of lives in the most severe category. (29.3% death rate vs. 41.4% death rate for those on ventilators). Doctors quickly started using the $20 steroid to save so many lived throughout the pandemic.
Instead of hyping the stuff that _WORKED_, the political system was hyping snake-oil like Hydroxychloroquine and Ivermectin. Why were so many people optimistic on such bullshit?
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Here is where being skeptical helps. Whenever Hydroxychloroquine or Ivermectin came up in a stupid discussion, I'd pivot the discussion towards Dexamethasone and Monoclonal antibodies. People need hope. People want hope. Before we had vaccines, people wanted to know that doctors had an idea of what to do. Dexamethasone and Monoclonal Antibodies did the job and did it properly (saving lives long before vaccines were developed). No one cared if it was "hydroxychloroquine" or "dexamethasone", these are all just giant chemical that few people memorize. People wanted hope, and it was important we kept that hope factually correct.
You can't promise the world with bullshit snake oil. When someone gets COVID19, they'll demand Ivermectin (yes, my sister is a doctor and she's seeing patients who are literally dying and demanding Ivermectin from her). Ivermectin has given these people false hope and is turning them away from the actual care that would save them.
Perhaps it's the very fact that dexamethasone was useful (and therefore used) that explains why you never hear about it.
Since you mentioned the political context, it's not necessarily just "something that works" that you're looking for in a political sense, but "something that works that THEY don't want you to have." If everyone agrees on it, there's no action, no wedge.
The fact that most people are going to recover anyway is also fertile ground for snake oil, as everyone runs their own uncontrolled experiment and declares success when they survive, and most do.
I think you missed the point. The idea here is that there were people that said before any results were in that hydroxychloroquine was not gonna work, operating with a heuristic that almost always works. And in this case they were correct, which the article doesn't seem to disagree with. The point is that at some point the heuristic will fail, not that it did in the case of hydroxychloroquine.
But it's worth pointing out that (i) the medical profession, who are the appropriate people to be evaluating HCQ, didn't rely on their heuristic but did the test and (ii) if you as a layman abandon the heuristic that you shouldn't be receptive to the advice of conspiracy theorists and alternative therapists protesting the medical profession because they might be right about something, following that advice isn't largely cost-free unlike the other examples Scott Alexander set up, and is in fact more likely to harm you than the heuristic
I remember hearing hydroxychloroquine conspiracy theories well into the election of November 2020. In particular, when Trump revealed his positive diagnosis, plenty of people were talking about Hydroxychloroquine at that point.
That crap was disproved 5 months earlier, and plenty of people still didn't get the news.
The article ignores useful treatments like Dexamethasone and monoclonal antibodies.
The correct skeptic was pro dexamethasone anti Hydroxychloroquine.
Seeing things from only an anti-htdroxychloroquine perspective is 100% misleading. There were working drugs that saved many lives during the stupid Hydroxychloroquine hype.
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What timeframe are we talking about here? What else was known and tested? There is a political group who kept pushing HCQ for months, and then mislead the public again with Ivermectin a few months later.
Ivermectin was entirely a 2021 phenomenon as well. Not only did we know that Dexamethasone + Monoclonal antibodies worked, we also had 3 competing vaccines and the "Pfizer anti-viral pill". Why the hell were people talking about the snake-oil Ivermectin?
But we weren't "heuristic following skeptics" with regard to the pandemic.
The RECOVERY trial basically tried everything that had a chance of working. Hydroxychloroquine was part of the tests and did very poorly.
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After the RECOVERY trial in June 2020, it was no longer about "what worked", the question was "what works better?". By the time Ivermectin became a discussion point in 2021, it wasn't good enough to just "work", you had to prove that it was at least as good as Dexamethasone + Monoclonal antibodies.
Its not about being a "heuristic following skeptic". Its about knowledge of treatments that do work and the tests they underwent to prove their efficacy.
The correct answer for Ivermectin was "Hey, we have this test with Dexamethasone + Monoclonal antibodies that showed efficacy over 3000 people. Where is the evidence for Ivermectin?"
Oh, you don't have evidence yet? How about we wait until you have evidence before you claim that IVM is more useful than the current Dexamethasone + Monoclonal antibodies cocktail?
"Extraordinary claims without evidence or rationale are bogus" as a heuristic seems pretty good to me?
When presented with a problem and infinite solutions, you need to start narrowing down which paths to investigate somehow. Come back with evidence and the conversation goes further.
We were confidently against Hydroxychloroquine because it was well tested in the RECOVERY trial in June 2020 [1].
The time to be optimistic was during the trial-phase of the test. Once that time passed, everything beyond that point was unnecessary and unhelpful hype.
------
What's amazing to me, is that the RECOVERY trials showed that Dexamethasone cut the death rates in half [2]. Where did the Dexamethasone hype go? Why was the political discussion on the snake-oil Hydroxychloroquine?
Even months before we had a vaccine, doctors had discovered how to save roughly 10% of lives in the most severe category. (29.3% death rate vs. 41.4% death rate for those on ventilators). Doctors quickly started using the $20 steroid to save so many lived throughout the pandemic.
Instead of hyping the stuff that _WORKED_, the political system was hyping snake-oil like Hydroxychloroquine and Ivermectin. Why were so many people optimistic on such bullshit?
------
Here is where being skeptical helps. Whenever Hydroxychloroquine or Ivermectin came up in a stupid discussion, I'd pivot the discussion towards Dexamethasone and Monoclonal antibodies. People need hope. People want hope. Before we had vaccines, people wanted to know that doctors had an idea of what to do. Dexamethasone and Monoclonal Antibodies did the job and did it properly (saving lives long before vaccines were developed). No one cared if it was "hydroxychloroquine" or "dexamethasone", these are all just giant chemical that few people memorize. People wanted hope, and it was important we kept that hope factually correct.
You can't promise the world with bullshit snake oil. When someone gets COVID19, they'll demand Ivermectin (yes, my sister is a doctor and she's seeing patients who are literally dying and demanding Ivermectin from her). Ivermectin has given these people false hope and is turning them away from the actual care that would save them.
[1]: https://www.recoverytrial.net/news/statement-from-the-chief-...
[2]https://www.nejm.org/doi/full/10.1056/nejmoa2021436