Remember those two challenges last week, that we marked as inconclusive [https://www.betterskeptics.com/
The below is a transcript of a DarkHorse Podcast with Pierre Kory & Bret Weinstein, published on June 1, 2021. The podcast is available on any podcast player or also in video format on Odysee.
The transcript was produced by GoTranscript.
[00:00:07] Dr. Bret Weinstein: Hey, folks. Welcome to the DarkHorse Podcast. I am Dr. Bret Weinstein. I am sitting with Dr. Pierre Kory, who is the president and chief medical officer of the FLCCC, which is the Front Line COVID-19 Critical Care Alliance. He is also a lung specialist and an ICU specialist. Welcome, Dr. Kory.
[00:00:29] Dr. Pierre Kory: Bret, thanks for having me. Really good to be here.
[00:00:31] Dr. Weinstein: I could not be more excited about this podcast. I really have the sense that the story that you and I are about to delve into couldn't possibly be more important. There's a tremendously hopeful aspect of it and there's a tremendously frightening aspect of it. I am just simply looking forward to having it in the world well-understood. Before we do that, though, I think I need to say a word or two in light of the fact that there is what we will talk about an industrial-strength campaign to censor this story.
I need to say something rather directly to those who are most likely to attempt to censor it. What I want to say is that Dr. Kory is not only an advocate for a therapy that is incredibly useful in the context of COVID-19, but he is also someone who has pioneered therapies already that are now the standard of care for COVID-19 patients. That means he has earned the right to talk about whatever he thinks is important.
For my part, as you know, I was also very early on the lab-leak hypothesis and I was very careful about how I presented it. Of course, in the last month, that hypothesis has been vindicated. Everyone, including Dr. Ralph Baric, who is the leading expert in the world on bat-borne coronaviruses and their modification in the lab, has acknowledged that a leak from a lab in Wuhan, China is plausible.
I have also earned the right to talk about what I want to talk about and what I think is necessary. We are now going to have a conversation. If you don't like it, that, YouTube, is your problem. We are entitled to discuss this because a lot depends on it and what we do when issues are complex is we hash them out and figure out what's true through dialectic. That's what we're going to do.
[00:02:28] Dr. Kory: I appreciate that you already said a few things, but I'd like that hopeful part because there is a lot of weirdness. The censorship is unpleasant, but ultimately, this is a message. There's a really hopeful message about science here. That's why I'm really glad to be here. I'm glad to see just more scientists have credibility, willing to really look at the evidence behind a phenomenally effective therapy. Like I said, I'm really happy to be here.
[00:02:57] Dr. Weinstein: Great. Well, let me say I think the evidence is incredibly compelling and that the fact that it is compelling and yet not widely known is an important fact in and of itself. There are layers to an onion to this story. Whatever it is that causes an obviously useful therapy to be suspected in ways that it shouldn't be based on the evidence, whatever that thing is, is also a disease of sorts. Somehow we have to get to a place where evidence-based medicine really means evidence-based medicine.
[00:03:33] Dr. Kory: I agree. No, you're right. I like that you just said "disease." It's a symptom of dysfunction in our system. Our system is creating this problem around a really effective medicine and it's really damaging.
[00:03:48] Dr. Weinstein: All right, so I'd like to step back a little bit. Obviously, the best thing to do from the point of view of an interesting discussion is go right to the heart of the matter, but I really think it's important that a couple of things are on the table first. Number one on that list is your organization, the FLCCC, is not an ivermectin organization.
[00:04:09] Dr. Kory: No.
[00:04:10] Dr. Weinstein: It was founded, as I understand it, to discover what the most useful therapies for COVID-19 were in the early days of the pandemic. Do you want to say something about where you started?
[00:04:21] Dr. Kory: Yes, so the first thing I have to say is that we start with Professor Paul Marik. Paul Marik is actually the most published intensivist in the history of our field, who's actually practicing medicine. The other doctor who published more doesn't see patients. Paul is a giant in our field, well-known internationally. What happened was when COVID was rolling to our shores and it really hit New York and Seattle, some prominent doctors went to Paul and said, "Hey, you got to come up with a protocol," because Paul's well-known for his protocols for sepsis and whatnot.
"Get a group of your colleagues. Put together a protocol to treat this," and that's what he did. I'm honored to be a member of that team. Paul and I started talking with the group and we put together a protocol. Our first protocol actually included blood thinners, pretty aggressive, and corticosteroids, at a time when every national and international society basically said there's insufficient evidence and do not use. In fact, they thought corticosteroids were harmful.
I was actually invited to give Senate testimony back in May, where I testified in the Senate that it was critical to use corticosteroids, that lives are being lost. As you might know, I got killed for that. We got killed for that. We were totally criticized for not having an evidence-based to say that on and we actually did. Our reading of the evidence was that you had to use it. That's how we came together. That was the first components of our protocol, but like you said, ivermectin was not in our protocol initially.
[00:05:58] Dr. Weinstein: I find this just stunning. You discovered as clinicians that corticosteroids and blood thinners were important in the treatment of COVID patients. In trying to make this point, you were criticized and then vindicated. This is now standard of care. Am I right?
[00:06:18] Dr. Kory: Both are standard of care.
[00:06:20] Dr. Weinstein: Standard of care. In thinking about this question, there's a barrage of nonsense that comes back when you even say the word "ivermectin." People have to realize who they're up against. They're up against people who have not only been successfully treating patients but have been innovating the standard of care. The very same people are now talking about ivermectin and its potential. That is the context in which what you say about this drug has to be taken.
[00:06:49] Dr. Kory: If you go to our website and you look at our résumé or our contributions to the field, you're going to see repeated contributions over decades. The world expert at steroids and lung diseases, Umberto Meduri, and he is part of our five that started the FLCCC. There's a lot of his guidance around steroids that we put it in our protocols. I keep saying you can't call upon more credibility and experience, not only in evidence-based but in clinical medicine, literally treating critical illnesses for decades and that's what we do.
[00:07:27] Dr. Weinstein: I have my own trajectory into this story, much later than yours. As I started to understand how strange this story was, and that, of course, spurred me on to dig deeper and deeper, the thing that I find so strange about it, I've been to a number of these battles. This isn't my first rodeo as some would say. In general, the people who one ends up defending in such a circumstance, they are fringe. They may have something very important to say, but there is something about them that is hard for people to understand at first.
You guys, you're blue chip. You guys are absolutely unimpeachable. You couldn't ask for better credentials. You couldn't ask for a better publication record. You guys are center of your discipline, and yet you are being dismissed as if you were kooks on the fringe making wild-eyed claims. I have to say, I haven't seen a battle like this and I'm a bit excited to see what happens when the heroes of the story are also squeaky clean and speaking plain English.
[00:08:45] Dr. Kory: We're not fringe. That's for sure.
[00:08:47] Dr. Weinstein: You're not fringe. Okay, that's remarkable. Before we get to the ivermectin question though, I do want to talk to you a little bit about what it looked like as you as a lung specialist, an ICU specialist, were encountering COVID patients and coming to understand what they were really sick with. I remember the early days of the pandemic and the groping for reason, why do the symptoms look like this? Is it a lung disease? Is it a blood disease? What is it? What did happen with these patients? What did you realize about them?
[00:09:20] Dr. Kory: [clears throat] Sorry about clearing my throat. What was clearly recognized early on is that it was a disease of phases. It started out as a general viral syndrome. Most people recovered, self-limited. It's like a cold, right? Sometimes a little bit more severe than a cold, but everyone quickly realized that around day five, seven, eight, there was a proportion of patients who suddenly started dropping their oxygen levels and, basically, their lungs were inflamed. We now know that it's the cell called the macrophage, which gets activated and literally attacks the lungs. You have this immune response that is attacking the lungs and the lungs start to fail.
[00:10:01] Dr. Weinstein: Macrophage is like an amoeba-like cell that goes around. Basically, garbage collector, so it's a little more than that?
[00:10:07] Dr. Kory: Yes, scavenger.
[00:10:08] Dr. Weinstein: It's a scavenger cell, so it was attacking the lung tissue.
[00:10:10] Dr. Kory: It's the front line of defense, right? It goes into the lungs and it causes a lot of inflammation and so that inflammation injures the lung. You could see the lungs starting not to work. It's predominantly a severe lung disease. What I will never forget in my life is those early months because, and I'm going to go back to that steroid thing, we saw patients just this disease marching straight to the ventilator and so many people were landing on ventilators. You remember, people were running out of ventilators.
There was two reasons for that. One is because the entire healthcare community globally said this is a viral disease, so supportive care, only. You're talking about Tylenol and fluids. As they did supportive care only because there was no randomized controlled trials letting them do like everyone talks about evidence-based, I was like, "What about experience-based medicine?" I've been doing this for 30 years. Why can't I do what my experience tells me to do? I don't have randomized controlled trials, but to do nothing was leading to ventilator shortages."
[00:11:20] Dr. Weinstein: I want to clear one thing up for my audience who won't be familiar with the terminology and then make a point about what you've just said. The first thing is, what did you call this policy of Tylenol and--
[00:11:35] Dr. Kory: Supportive care only.
[00:11:36] Dr. Weinstein: Supportive care only. The idea here is that, historically speaking, we have had very little to do about viruses. We've been tremendously effective with antibiotics against bacteria, against fungi. They don't in general work against viruses and antiviral therapies have been a dicey business for a long time. What does work has been vaccines. If you get to a pandemic and you don't have a vaccine, what you were effectively being told is, "Look, there's not a whole lot of positive intervention you can do, so let's just make them comfortable. Rescue them if they need to be rescued. Other than that, hands off."
[00:12:17] Dr. Kory: Here's one of the mistakes. It is correct to say we don't have good antiviral therapies. It's incorrect to say that they were dying of the virus. We knew relatively early on. By the time they get to the ICU and they're that sick, there's not a lot of viral replication going on. In fact, you can't culture virus after about day seven or eight. It's actually a disease of inflammation, not viral invasion. In fact, in autopsy series, only 20% do they find what's called cytopathic changes from the virus into the lung. You didn't have to go after the virus at that point. You had to actually check the inflammation.
[00:12:55] Dr. Weinstein: Again, I want to do a little translation for the audience. Inflammation-- and by the way, this is a place where I would take doctors to task, but doctors often treat something like inflammation as if it's simply bad. The fact is inflammation is an adaptation that often gets out of control and it can easily kill you, right?
[00:13:13] Dr. Kory: Overexuberant, and so we have to bring it into check.
[00:13:16] Dr. Weinstein: What you're telling me is that COVID patients were infected with the virus. It triggered a pathway that is part of healing but triggered an overreaction. The patients who were dying on these ventilators weren't really dying of the virus being so very active. They were dying of this cascade of events that follows the body's attempt to fight off a pathogen it's never seen?
[00:13:38] Dr. Kory: It was a reaction to the-- In fact, one of the most impressive studies that Paul actually highlighted is that what we think triggers inflammation is actually the viral debris. It's the RNA that actually has this-- it triggers this massive response to the body. It's not the virus, it's actually the debris of the dead virus that does it.
[00:13:59] Dr. Weinstein: Well, let me flag something for the future. My advisor, who's now gone, a guy named Dick Alexander, used to talk about the point in a respiratory illness when you stop coughing on behalf of your virus and start coughing on your own behalf. The point he was making was that, actually, these pathogens necessarily induce changes that cause them to be passed on. They will create irritation. They will create inflammation. They will create all kinds of phenomena that are symptoms that are actually, basically, the ecology that allows them to thrive.
[00:14:39] Dr. Kory: To transmit.
[00:14:40] Dr. Weinstein: In a sense, I don't know why it's the viral debris. There's a pretty good chance that this virus learned that by creating debris, it could cause a lot of stuff to accumulate in the lungs that got ejected in some chaotic way. Who knows?
[00:14:53] Dr. Kory: It could be. I didn't think of it that way.
[00:14:55] Dr. Weinstein: It's worth thinking about. The other point I wanted to make in reference to your sense as a clinician that you were effectively having your hands tied behind your back when you knew a whole lot about patients and we're learning more every day, you needed to be free to try things. The point I would make is once upon a time before we were born, doctors were scientists. They had fewer tools, but what they had was a whole lot of experience.
I want to bring attention to the house call, which has now effectively gone extinct. The house call allowed a doctor who didn't have a huge range of pharmacological agents or tools at his disposal, but what he did have was the ability to observe patterns, right? If people on one side of town were sick with something and people on the other side of town weren't, maybe there was something in the water, for example. Anyway, that ability to observe patterns was part of a scientific mindset that my impression, having interacted with doctors over my lifetime, is that that mindset has basically dwindled.
[00:16:03] Dr. Kory: I love that you're going back because I love the history of medicine. When I read stuff from 100 years ago, you're constantly shocked by how much they knew with very little of-- I mean, they don't have the experiments or the techniques to discover what now we know. They did it all by powers of observation. Really, medicine was created by the best doctors who had the keenest power.
The giants of medicine had these unbelievable powers of observation and they were able to do a lot. That's why I always say to my students, I always say that what separates them from me is we've read the same books. We all have the textbooks, I said, but an expert has pattern recognition. You just see diseases play out. You see how different people react to same illnesses and you just get to see patterns and patterns.
What happened to me, I love talking about this, but every time I came to the bedside of a patient and there was something wrong with them, I always had to very deliberately analyze like it could be this and this and this. After about a couple of years being immersed in ICU medicine, I noticed that I could now walk into a room and just with very little information, just know what was going on. It suddenly became like intuitive and second nature. It was all just about observing patterns and so I think that's really key.
That's why with this disease, this is not an ego exercise, but we knew you had to anticoagulate these patients within four patients. We knew they were clotting to degrees that we hadn't seen. There was so much controversy around putting someone on a blood thinner, which people are put on blood thinners in hospitals for far less reasons than we were promoting with this. It was just evidence-based maniacism. It was bizarre. Now, you can't observe. You can't make clinical reasoning. You can't deduce. You need a trial before you do anything.
[00:17:59] Dr. Weinstein: Okay, so this is, I must tell you, exactly the same thing in my field, right? The people who are really good, evolutionary biologists or ecologists, evolutionary ecologists in the best cases, have intuition. They know how to follow a hunch. They know how to figure out when their hunches are wrong, right? The point is it's an art more than a science actually.
[00:18:20] Dr. Kory: No question.
[00:18:21] Dr. Weinstein: In the case of a brand new pandemic that is spreading like wildfire, this is, of course, exactly the mindset that you want. You want people who are capable of deducing that there is some pattern and then figuring out whether they were fooled by some sort of noise pattern or whether it was actually something, testing a hypothesis, but there is a point at which you know and you know better than a study because you've acted on that hunch.
You've seen that the patients get better and it happens enough times that it can't be random. Anyway, there's something about the mindset of the moment in which it's all about peer review and these published peer-reviewed papers. It's all about the official guidance from the WHO and the CDC. It's basically a kind of intellectual authoritarianism that is so bizarre in the context of a complex system like medicine, especially in the context of a brand new disease that we're all not experts in. There are no experts that we can simply default to. Everybody is a novice.
[00:19:23] Dr. Kory: I like that term "intellectual authoritarianism." I don't know that it was occurring to this degree or even remotely to this degree pre-COVID. Actually, I looked around in COVID and I started to see all the institutions coming up with their treatment protocols. You weren't allowed to stray from the protocol even if you're an expert. Literally, the leaders of the hospitals were saying, "Don't use--" and you couldn't do anything else. You couldn't actually doctor and, suddenly, I felt like I was being handcuffed. It was bizarre. I've never seen that in my life before.
[00:19:58] Dr. Weinstein: I have the sense that doctors have been demoted, forcibly demoted from the position of scientific clinician to technician. The point is you're really delivering a prepackaged good more than you are coming to understand your patient and what they're sick with and what they therefore need. It's a travesty.
[00:20:18] Dr. Kory: I've never been asked to do that before. I've always been asked to use the best extent of my experience and judgment and insight to best help the patient. That's the oath I took. The oath wasn't, "Do what the gods of science--" Paul calls the healthcare leaders the gods of science and knowledge because [chuckles] we're just little mortals and we have to listen to the gods. I've never been asked that before to get advice from.
Oftentimes, I'm sorry, but I don't want to sound so dismissive, but many of them are really desk jockeys. They're not on the front lines. They're reading some papers. They think they know what the disease is. They don't know what this disease is. They're not sweating it out, seeing day to day, the manifestations, the responses to therapy, the lack of responses. They don't understand this disease, and yet they're telling everyone how to treat it. We want a seat at the table, expert clinicians. Where's the expert clinician committee?
[00:21:18] Dr. Weinstein: Right, I absolutely agree. You see that at the level of doctoring. I see that at the level of the pandemic itself, right? The fact is we have a novel phenomenon. It came potentially from an unusual source, right? A knowable source potentially. What we are supposed to do about it to actually take care of it so that it does not become a permanent fellow traveler of humanity, that takes really smart, insightful, courageous people who have been totally liberated to have whatever discussions need to be had. Instead, we're in a situation where if we open our mouths and say the wrong word, suddenly, there are warnings appended to what we've said. It's insane.
[00:22:01] Dr. Kory: It's limiting discussion, limiting choices, limiting approaches. It's hard, yes. I don't know. Did we all forget the history books that we read? When has censorship ever been a good thing?
[00:22:15] Dr. Weinstein: When are the censors ever the good guys?
[00:22:18] Dr. Kory: When has that ever led to a societal good?
[00:22:22] Dr. Weinstein: I really hope that whatever thing it is inside of YouTube and Twitter and Facebook and LinkedIn that has its meetings, I hope they look at this and they sit down and somebody in the room is courageous enough to look at everybody else and say, "Are we the bad guys in the story? If so, how did that happen?"
[00:22:44] Dr. Kory: I get the intention. You want to protect people because medical misinformation might harm them. I have two problems with that, which is if you're going to limit science, that's antithetical to science. Science is about exploration, hypotheses. Science is never discovered at the NIH building. It's actually the people on the ground doing experiments, making deductions. We should flow the information to them, not they flow information to us.
[00:23:13] Dr. Weinstein: Not the other way around.
[00:23:15] Dr. Kory: That is that. Then the placing of medical misinformation on a par with violent hate speech, White supremacy, I'm sorry, but medical misinformation, it's not as harmful as you would think. People are afraid that you need to espouse some medicine that's not going to work and you're going to hurt someone. I think people do not need to be protected to that extent. People have judgment. They do lots of things in the world. You know what I'm saying? Censorship is not the answer to that.
[00:23:46] Dr. Weinstein: Well, I would say the problem is that you get the harm to people on both sides. If you try to constrain things to only the information that we're really, really, really certain of, you're going to kill a lot of people because you're not going to benefit from the exploration. If I can actually just draw an analogy between what you do with your individual patients and the situation that civilization is caught in with COVID more broadly in the ICU and-- I don't know. I've never been an ICU doc. In the ICU, you are dealing with people who are really sick. Their lives are on the line.
[00:24:26] Dr. Kory: They're the sickest of the sick.
[00:24:28] Dr. Weinstein: Right. Now, if I'm in that bed and you're my doctor, my sense is I do not want you so terrified that you may kill me trying to help me that you are paralyzed. I want you to take your best shot at getting me through it. I am accepting that you may kill me because the chances are you're more likely to help me. When we are talking about the question of what these therapies are, we are in the middle of a brand new disease. We are discovering it. It turned out that you were wrong about ivermectin, then some people would die.
The number of people who have already died because we haven't used this drug, it's absolutely immense. The point is, look, let's be adults about this. People are dying. They are dying. What we would like to figure out as quickly as possible is, what is the way to reduce that number? I also think we over-focus on death. The amount of damage that people are suffering, who get sick and recover is immense too. Those people will lose years of their lives.
[00:25:38] Dr. Kory: No question.
[00:25:39] Dr. Weinstein: The question really is, how do we minimize the net harm of this disease? The answer is there is no way to do it without some people dying as we get our bearings. There's no way to do it.
[00:25:51] Dr. Kory: I agree. Umberto Meduri talks about this a lot is that we are just demoralized at the lack of really emergency thinking, which is a risk-benefit now. Everything I do at the bedside of a patient is a risk-benefit. Anytime I prescribe a medicine, it's because I believe that the chances of benefit are greater than the harm. You can do that on any amount of evidence. You can do it on unassailable mountains of evidence. You could also do it on little evidence, but you're going to make a risk-benefit ratio. The idea that we're not going to use a really safe drug, which every study shows nothing but benefit, and why we're not employing it?
[00:26:31] Dr. Weinstein: Well, this is the impossible question. I will say when I started to detect the message that you guys were sending out, I was cautious about it. I looked at this and I thought, "Whoa."
[00:26:42] Dr. Kory: Fair, be cautious.
[00:26:44] Dr. Weinstein: There's a drug. It has positive effects. Why am I not seeing it discussed more? Then as I went deeper into the evidence and as you all generated more evidence and put it into the world and as the natural experiments that are in the world revealed themselves and showed the very same pattern, it became clear that this was actually taken in the aggregate. The amount of evidence is incredible, right? This is a very clear signal.
It'd be hard to miss it unless that was your purpose unless you had some confusion or reason not to want to know. Then if you extrapolate from that, you get into some very strange territory about why in light of this tool that is apparently at our disposal, safe, highly effective, not only highly effective at treating these patients but preventing people from coming down with COVID. What would it mean if we had that at our disposal and didn't use it? Let's talk a little bit about the evidence. What is ivermectin? Can you--
[00:27:46] Dr. Kory: Ivermectin, it's one of the most common medicines in the world. It actually works against parasites, so worms, different parasitic diseases that affect humans and animals. It's very common medicine given to animals. It also won the Nobel Prize because it essentially transformed the health status of huge portions of the globe. There's a lot of continents where parasitic diseases were endemic and absolutely decimated the health status of really low and middle-income countries. One of them is a disease called onchocerciasis or river blindness.
It literally causes blindness. There were some populations in Africa, some societies where I think it's like 50% of the men by the time of age 40 were blind. You had villages where all the people were blind. Here comes ivermectin known to be this really effective and it basically eradicated the disease. It's been used now for 40 years, 4 billion doses. The WHO has administered mass distribution programs to many of those areas. For that reason, it's one of the greatest feats of a medicine in history. Maybe not as big as penicillin. That's one of the biggest discoveries. Literally, it's on that shelf, right? That's just parasites.
[00:29:11] Dr. Weinstein: As I understand the story, it's discovered in the early '70s?
[00:29:16] Dr. Kory: The first discovery is identified in '70, '75.
[00:29:20] Dr. Weinstein: By Satoshi Ōmura, a Japanese. Is he a scientist?
[00:29:25] Dr. Kory: Yes, he's a scientist, biologist.
[00:29:27] Dr. Weinstein: He discovered it in-- it was produced in the soil by bacteria, I think.
[00:29:31] Dr. Kory: Yes, what he was doing, his expertise was looking at substances made by microorganisms like penicillin and what their effects were as a medicine against other organisms because many organisms make substances to ward off other organisms. He would take organisms from the soil and look at the substance they created, and then test them as medicines. That was his expertise.
What's so fascinating about ivermectin is that he found the microorganism near a golf course outside of Tokyo. It's an organism called streptomyces. It made this substance, which is actually called avermectin. To this day, that microorganism in Japan is still the only place you can find. Now, it's obviously produced everywhere, but the source is still in the soil in Japan. It's never been found from any other sources.
[00:30:27] Dr. Weinstein: It's endemic.
[00:30:28] Dr. Kory: It's really wild, his discovery.
[00:30:31] Dr. Weinstein: That's cool. I must say, as an evolutionary biologist, this also strikes a chord because I am much more concerned about a totally novel molecule that we have created in a laboratory. The reason I'm more concerned about it is that there's every possibility when you create something in the laboratory that our ancestors who will never have encountered anything like it and, therefore, our bodies may not know what to do with it, but a natural molecule is something you can't.
Obviously, if it's endemic to Japan, most of our ancestors probably never encountered the exact molecule, but the chances that they have encountered many molecules like it and, therefore, will be able to process it in some reasonable way is very, very high. Unlike something like Tylenol, for example, which seems very safe but is actually quite destructive of the liver.
[00:31:21] Dr. Kory: It can be toxic, yes.
[00:31:22] Dr. Weinstein: Especially in combination with alcohol. You just don't foresee how dangerous a molecule you've ingested because it's so common. Anyway, okay, so ivermectin is discovered 2015. It wins the Nobel Prize.
[00:31:35] Dr. Kory: Well, yes, because really that was in recognition not only of the discovery but really the impacts on global health. The WHO, it's like some of the heyday of the WHO is their early work on some of those diseases, but the story goes on. Around 2012, the first study started coming out of labs in virus models. They started looking at cell culture models in labs. They showed that ivermectin was working against Zika and dengue and West Nile and influenza.
It was showing antiviral properties in experiments. Here, you have this phenomenal anti-parasite drug. Now, it's showing that it has efficacy against viruses. That's where the antiviral story, which is, I think-- again, we're going to talk about it in terms of COVID, but I actually think I'm so-- Go back to the hopeful part. I am so interested in the future of this drug against other viruses as well. Before we get to that, we should talk about COVID.
[00:32:40] Dr. Weinstein: Yes, but I think this fits beautifully. It's not like this was-- When I heard that ivermectin had some utility and then I looked into the evidence for it, my assumption was that people were just throwing random molecules to see what stuck. That is a more tenuous connection then. Actually, this does have broad antiviral effect.
[00:33:01] Dr. Kory: 10 years of experiments. There just haven't been clinical trials of it, right? Then you know the story with COVID is that a group in Australia published a study, I think it was late April of 2020, showing that in their cell culture model, it basically eradicated all viral material within 48 hours. It showed this phenomenal efficacy in the petri dish, in the lab. I always say, and you're going to know this too, very few molecules make it from the bench to the bedside.
There's a whole bunch of stuff that has to happen. The concentrations have to be appropriate, the safety has-- and then it has to work in a human model because we're not Petri dishes, but anyway, very few can make that leap and then hit the goals of safety and efficacy and at an adequate concentration to be effective. Great, it worked in the lab. Now, remember, that was the time where, literally, the world was going insane.
People were dying. There's so much that was going on that a couple of countries, Peru, in particular, they did the boldest move and because of it-- That was really emergency thinking, emergency action. Actually, in their national health ministry, they got together, they saw what was happening on the ground in Peru. Based on a basic science lab experiment, they recommended ivermectin to the population.
[00:34:29] Dr. Weinstein: Which is not crazy because as you point out, there's a lot that can go wrong between the bench and the bedside, but in this case, it wasn't like some molecule works at the bench. What the hell is going to happen--
[00:34:39] Dr. Kory: You knew it was safe.
[00:34:41] Dr. Weinstein: You knew it was safe because so many people had taken it.
[00:34:43] Dr. Kory: You knew it was safe. It may not work in the human as it did in the-- but you knew that you weren't going to hurt anyone, right?
[00:34:49] Dr. Weinstein: Right, so why not try it? Then you would imagine, the evidence would accumulate. If it works in people and it's safe enough to try it and you've got an emergency situation where you don't have another effective therapy, then, okay, you give it to people. It's a Hail Mary, but lo and behold, the evidence accumulates. What happened?
[00:35:07] Dr. Kory: It was very controversial.
[00:35:10] Dr. Weinstein: Okay.
[00:35:11] Dr. Kory: First of all, a couple of things happened. The way I understand in the beginning is that it was part of the national guideline, but it was really attacked. A lot of scientists thought that was irresponsible, unproven. The cry is this insufficient evidence that I always hear and that actually probably applied back then. There was really not sufficient evidence, but you could say on a risk-benefit ratio, it's reasonable.
Anyway, it was very controversial. It wasn't widely adopted. I think a lot of people didn't agree with that. Fairly soon after that, after a lot of discussion, they removed it from the national guidelines. However, many states did adopt it and began to distribute ivermectin in Peru. What you saw in those states, every time they began a campaign, they began at different times across the summer, spring and summer.
Every time, it was followed by precipitous declines in case counts and deaths. Really, the excess deaths were plummeting in all these regions in Peru. What's interesting, what I think is a landmark paper and probably one of the most important people in this story besides Paul Marik, so going back to that identification of the evidence is when we talk about pattern recognition, it's really Paul who identified that there was something happening around ivermectin.
He noticed this pattern based on just a few studies. He saw the magnitudes and what it was showing and he says, "I think this is something real," because we've been studying all of the trials on everything. So many were failing, so many were conflicting, unsatisfying, but here comes ivermectin and the signal around ivermectin was really astonishing. Even the lead researcher for Unitaid and WHO, he found it remarkable too.
There was a team that was looking at repurposed drugs since last June. They were on their seventh molecule and he had heard about ivermectin. I think it was because of our advocacy. Suddenly, that's all they studied and he saw the same thing. He saw everything breaking in this remarkable, reproducible consistency around ivermectin. It's just an astonishing story in that way, but--
[00:37:18] Dr. Weinstein: Remind me-- I think you said, but when was that?
[00:37:22] Dr. Kory: I think the first studies that Paul said, "I think we got something here," was about mid-October. It would be a cool, historical-- if you look at-
[00:37:31] Dr. Weinstein: - mid-October 2020.
[00:37:32] Dr. Kory: Yes, mid-October 2020. Remember, we did not have ivermectin on our protocols. We actually didn't even have-- The FLCC did not have an early treatment protocol. Paul Marik did-- at his medical school, he had put down some general recommendations of stuff you could do, a nutritional and vitamin supplementation to prevent and some stuff with antiviral properties like melatonin and zinc and an outpatient regimen. We didn't have one as part of the FLCCC, but we were watching.
Then Paul always had ivermectin on his protocol with a question mark because we just didn't have the data to really recommend it. When Paul started to see these trials and they were really very profound, the benefits, we put it on and we put together a protocol. My paper, the pre-print went up November 13th because after Paul started to talk about it, I got intrigued. I dove in right behind him. I just started reading and reading and reading and looking at all these papers and I started to put together a review paper. The first draft was November 13th, which is like three years ago. [chuckles] It feels like three years ago.
[00:38:39] Dr. Weinstein: Yes, it seems like it.
[00:38:40] Dr. Kory: What I want to also mention is another character in the story besides Paul is a man named Juan Chamie. He's actually a business data analyst and he's from South America. Starting back in June, he'd heard from friends in Colombia that they were using ivermectin. They said, "This stuff works." He'd heard just on the ground that people who are taking ivermectin just did really well. They weren't getting sick and it seemed to be effective.
He started looking at all publicly available databases in different regions and he started to notice a pattern. He has been posting and publishing these graphs for a year now. They all show reproducible benefits at a population-based level whenever ivermectin is adopted into guidelines or used in a city or region. We have masses of evidence showing that it's working epidemiologically on that kind of data.
His paper, which he wrote with a couple of other experts, it's now in peer review, but I think it's a historic landmark paper. What they did is they showed the relationship of the states in Peru, the distribution of ivermectin, and what happened to the case counts and deaths. They very carefully ruled out all the other confounders like lockdowns and mobility and mask-wearing and everything.
They show you there's nothing else to explain those precipitous drops but ivermectin. I think that paper-- and so what's interesting is Paul identified it. I fell in behind Paul. I started looking at all the clinical evidence and then one day, I found Juan Chamie's paper on a pre-print server. Literally, I think there was goosebumps going through me as I'm looking at this paper. I already knew that this was probably a gangbuster for medicine, but I saw the paper showing that it's actually working on a population-based level in Peru.
I called Paul. I'm like, "Paul, I just sent you this paper. You've got to look at it." Paul was not as surprised as me because I think Paul knows everything. He already knew that ivermectin was capable, but I thought it was really important because this was like the-- there's no better evidence that, you know-- Never mind randomized controlled trials. You're seeing thousands upon thousands of people not dying in society.
[00:41:00] Dr. Weinstein: I know exactly what you're getting at. There's a signal that's so strong and I've now seen it in the papers. Largely, your group has directed the world who is paying attention to this. We have a very tiny fraction of the world but has directed us to the evidence and the evidence is unambiguous. It's this tremendous signal. It is maddening, I must say, to hear the responses, the finger-wagging that comes from officialdom and all of the people who are repeating these claims that-- I remember that remarkable AP Fact Check in which they said that there was no evidence that it was a miracle drug as if that sentence even means anything.
Then, basically, the point was, well, of course, there is evidence, but it's not of the gold standard type, what we'd really ideally in a perfect universe-like is gigantic randomized controlled trials. Well, okay, yes, in a perfect world, you'd have that. Absent that, it doesn't mean you know nothing. The evidence here is so strong on so many different fronts that it must have been incredibly frustrating to see the effects reflected in different kinds of data and then to be told, "Well, that doesn't mean anything." It's not like you saw a patient get better, right? You saw this happening at every scale.
[00:42:31] Dr. Kory: I also say the man that I was back in October and we already struggled getting our message out of effective treatment protocols, but I never could have imagined this. I'll tell you how naive I was. By the way, I borrowed your phrase the other day. What is it? "No matter how cynical I get, it turns out I'm naive," or something. [chuckles]
[00:42:50] Dr. Weinstein: Yes, "No matter how cynical you get, you're still being naive."
[00:42:53] Dr. Kory: "You're still being naive," yes. I have learned that lesson, I keep learning that lesson, how naive I am. Let me tell you how naive I was when I posted our pre-print November 13th. I literally thought the pandemic was over. [chuckles] Posted it, it's there. We showed the basic science level. We showed multiple clinical trials. We showed the epidemiological effects. Everything was there to show that this is an intervention on the power of vaccines that could literally extinguish the pandemic. What happened? Crickets.
[00:43:32] Dr. Weinstein: Crickets, yes.
[00:43:33] Dr. Kory: [laughs] Literally crickets. That's a whole other story, which we're going to talk about. That's what I thought at the beginning, is that it was as simple as putting the evidence out there. When you said "gold standard," you know that triggers me because you're talking about it doesn't have the gold, gold, gold standard. It has dozens of randomized controlled trials, which is the gold standard. It just doesn't have a Big Pharma-conducted or what I say North American or Western European-conducted trial.
[00:44:06] Dr. Weinstein: Right. Now, this is clearly, clearly based on the quality of the evidence that does exist and the fact that the meta-analyses reflect that in spades and that meta-analyses are awesome because they correct for the biases of any individual study and on and on and on, but this is clearly obstructionist. The claim that this is not good enough to act on when people are dying, that is preposterous.
The experience of feeling like, "Well, I did the work. I did it the way I was supposed to do it. The thing that I'm pointing to is good enough. My work here is done. Now, we're going to get to the part where things start getting better quickly," and then nothing happens, that's actually part and parcel of-- I call it the phenomenon where you can detect something based on the gravity it exerts. You can't see it. It's like one of those planets that was discovered because it pulled on something else. You know there's something out there, right?
[00:45:00] Dr. Kory: Yes.
[00:45:01] Dr. Weinstein: It's pulling on something and it's big. You can tell how big it is, but you don't know what it is. You can't see it.
[00:45:05] Dr. Kory: Right, it's a really interesting analogy.
[00:45:08] Dr. Weinstein: Yes, so in this case-- I hear you, brother. You did the work. It should have been good enough and then something else happened. Crickets as you describe it.
[00:45:18] Dr. Kory: I just want to take a second just to talk about how massive of a problem that is. The fact that our public health agencies are basically limiting the choices and the treatments that they champion and they're literally excluding this one. They have failed their goal of protecting the global health of citizens. I think it's a colossal and it will be a historic injustice to the world.
[00:45:47] Dr. Weinstein: You're being kind.
[00:45:50] Dr. Kory: I cannot believe that this is occurring. Literally, people are dying because they don't know about this medicine. Providers are being told not to use the medicine.
[00:46:03] Dr. Weinstein: They're feeling that their licenses are jeopardized if they do what's in the interest of their patients.
[00:46:09] Dr. Kory: I've never studied a medicine which has more evidence than this. You talked about meta-analysis. Everybody's waiting for this big randomized controlled trial, which oddly isn't really being done, right?
[00:46:20] Dr. Weinstein: Right, that's how you know this is obstructionist.
[00:46:24] Dr. Kory: Well, actually, that's not necessarily true. There is a trial that was funded in large part by philanthropy that we know about that's being conducted. That trial will probably meet these ever-elusive criteria of the trial. You have dozens of randomized controlled trials conducted by interested and committed clinicians from oftentimes low and middle-income countries around the world and there's no conflicts of interest.
None of them are going to make a million dollars by finding out that ivermectin works in COVID. None of them have a conflict of interest. What kills me is that I have been battling the evidence-based maniacs before COVID because there are certain treatments that I know work. Usually, I have to argue with these interventions, with the ivory tower EBMers, right? I usually have to argue around observational controlled trials because that's a different design where you don't necessarily have randomized two groups that are totally equal.
A lot of times, you look back and you see who got the drug and who didn't. There are problems with those trials. You can argue that observational controlled trials, some of them may not be the highest quality. I've never been in an argument where you literally have a stack of two dozen randomized controlled trials, and yet someone will look at you in the face and say, "They're small, poorly conducted. You don't know the follow-up. You don't know the allocation concealment, randomization strategy." They get so hyper-granted. You know the forest for the trees?
[00:47:59] Dr. Weinstein: Yes.
[00:48:00] Dr. Kory: Literally, they're hacking down these little trees, and then you have this decimated forest. Where's the data gone? It's crazy.
[00:48:09] Dr. Weinstein: It's obviously obstructionist. The point is ivermectin is not going to be allowed to be an effective treatment. That's the point. It's not about whether it is an effective treatment or whether you can establish that based on the available evidence. It's whether or not that will be formally allowed into the effective medical court.
[00:48:28] Dr. Kory: Let's go back to my evolution. I thought that this was a data argument in the beginning. Actually, to be honest, I want to be fair. There are some scientists who legitimately will look at it that way, that it is insufficient data, poorly constructed trials. You don't know who's doing these trials. They really just are suspicious of this. There are some who scientifically objective.
I think they're bizarre and I think they're crazy and they should get away from my patients, but there is another reason why ivermectin. There is a much more sinister one, but I thought it was a data argument. I kept trying to argue data-- I would say, "But you know, meta-analyses are stronger than any big trial. You don't need a big trial." I would have these data arguments, but it's not about the data. There's something else. There's that thing--
[00:49:15] Dr. Weinstein: There's the gravity.
[00:49:16] Dr. Kory: There's that thing that we can see and feel out there that is just squashing, distorting, suppressing the efficacy of ivermectin and it's egregious.
[00:49:26] Dr. Weinstein: Well, and it's not even difficult to prove it, right?
[00:49:29] Dr. Kory: No.
[00:49:30] Dr. Weinstein: For one thing, you can see it on the social media platforms. In fact, it's in YouTube's community guidelines, "Thou shalt not mention," blah, blah, blah. The point is, okay, to the extent that something like YouTube might be confused, it is confused into thinking that what the WHO says is God-given. Well, even if it was convinced of that a month ago, which there is no basis for it to be convinced of that, but even if it was convinced of that a month ago, they've just seen that the WHO massively misstepped on the lab leak. To the extent that they might have been dumb enough to think it was smart to prevent people from talking about stuff the WHO said wasn't real, they now know that you have to be able to critique the WHO. Why are we in a different place with ivermectin? Because this isn't about data, as you say. This is about something else.
[00:50:27] Dr. Kory: There are forces that are seeking to make sure that ivermectin is not accepted widely as an effective therapy.
[00:50:35] Dr. Weinstein: Despite the fact that millions are dying.
[00:50:38] Dr. Kory: It still leaves me speechless.
[00:50:41] Dr. Weinstein: Let's talk a little bit about the evidence and the patterns, and then we will talk about why and how the message is being silenced. When you say this could end the pandemic-- I have a friend online who's done a very good analysis, which is on my Twitter feed if people want to look for it, a data analyst from Brazil. He is very supportive. He agrees completely that ivermectin is a very important potential treatment for COVID and that we should be using and he quotes a chapter and verse.
He says that it is overreaching to imagine this could end the pandemic. Now, I think he's incorrect, and I think I know why he's incorrect. He's obviously an honest broker, but I think he's being too cautious. I would like to hear you, you've just said that you think it could end the pandemic, why do you say that?
[00:51:37] Dr. Kory: First, I want to guess why he'd said that. Maybe because just based on the trial's evidence, he doesn't see it as being as effective as it could be. A couple of reasons why I think he's underestimating its power is that the trials really can capture the efficacy perfectly, because trials generally don't start day one. The randomized control trials, by the time you identify, have symptoms, test, enroll, consent, and begin treat, you're talking about days. What we know in clinical experience is that you treat upon first symptoms, almost everyone gets better very, very quickly.
[00:52:15] Dr. Weinstein: Say that again slowly. If you treat COVID-19 patients on first symptoms with ivermectin, almost everybody gets better quickly. Is that what you say?
[00:52:23] Dr. Kory: Clearly. I see it in my own clinical experience. We talk about all the buckets of data. You have the randomized control trials, the observational control trials which everyone likes to dismiss because they're too fraught with, I don't know, inaccuracies which is false, but I try to remind everyone that randomized and observational around this both match each other.
In fact, there are times when the randomized control trials show bigger effects than the observational. We have randomized. You have observational. You have case series. You have epidemiologic analyses, and then the clinical experience of doctors. You can't find a doctor who has incorporated ivermectin into their treatments who will come back and say, "My patients didn't get better."
You can't find that doctor. I'm still looking for that doctor. Anyone who starts to use it-- what I found the first few times I used it is that generally, almost always, within 24 hours of starting it, some mitigation of one important symptom started to go away.
[00:53:24] Dr. Weinstein: Even when you give it to them late?
[00:53:26] Dr. Kory: Yes, even when you give it to them late. You start some diminution in some symptoms. Either the fever would break, or the tightness in the chest would go down, or the fatigue would lift in some way, but you'd see these very rapid responses upon treatment. The clinical experience is vast.
[00:53:41] Dr. Weinstein: It's vast and unambiguous.
[00:53:43] Dr. Kory: Unambiguous. If you know how to treat patients, and you are a good student, and you're a good clinician which is to say a keen observer of diseases in patients who are ill, you can see these dramatic impacts of ivermectin. What I think your friend may not be aware of is what's happening in the world on a population-based level.
The best example, and we'll get to India in a second, but Mexico did something which I think is the model for the world, and I think on a public health level, it's what every country in the world should adopt at a minimum.
What they did is they did have that clinicians committee. They actually got expert clinicians, they gave them a seat at the table at the public health level, it's called IMSS, it's called Instituto Mexical Social Seguridad. I probably butchered that. That's actually the agency which controls a good portion of their healthcare infrastructure, mostly outpatient, I think. They control all the testing centers. They were getting rolled, back in December. Hospitals were filled. It was like a crisis almost like in India.
They decided to deploy ivermectin using a test and treat strategy. Basically, anyone who appeared at the testing booths, if you tested positive, you got a rapid test, if you were positive, you were given ivermectin, at a reasonably low dose actually. It was only 12 milligrams, which for me, would be a low dose, and only two days' worth, they got four pills. When they did that, you saw, across Mexico, this precipitous decline in deaths and hospitalizations.
If you look, a few months later, right now-- this is publicly available data. Look at the occupancy of beds in hospitals in Mexico throughout the entire country, you're talking about 25% to 30% occupancy. There's nobody in the hospitals in Mexico. They've basically decimated COVID in that country by using a test and treat strategy, which actually could be optimized. In fact, I think-- never mind the test and treat, every cupboard should have ivermectin and you take it upon the first sniffle or the first fever.
[00:55:54] Dr. Weinstein: I must tell you. When I started to see the data on ivermectin and to understand the implications, I immediately sourced it, because my sense was, I did not at the point that somebody in my family got sick, I wanted it to be instantaneous. I did not want to have to figure out how to get it at that point.
[00:56:12] Dr. Kory: Bret, let's go back to the naive part of me. When I posted the pre-print, I was not confused in the least that there would be a global run on ivermectin, and all supplies would be decimated within weeks. I prescribed in bulk. I got it from a Canadian pharmacy, and I had a large amount sent to my house, because I was sure that stores would be depleted. It was back in November. Now, it is starting to happen in some areas. Talk about Mexico which I just applaud, those were real public health leaders.
[00:56:46] Dr. Weinstein: They did it the right way.
[00:56:47] Dr. Kory: They made a risk-benefit decision. They used their clinical judgment expertise, they had the right people at the table, and they got attacked by the Federal Health Ministry. In fact, there was a little argument because the Federal Health Ministry, much more allied with the WHO, was very much against what they did. They fought back. There's a couple of really interesting newspaper articles where the heads of the two agencies, one was holding up the WHO document saying, "There's insufficient evidence." and the other is saying, "Listen, we very carefully thought about this, we analyzed the evidence, and we did what we thought was right for the patients."
They posted their study, very careful study, showing anywhere between 50% and 75% reduction in hospitalization if you took ivermectin, at that dose, and only for that duration. I think that's the minimum of what ivermectin is capable of.
[00:57:35] Dr. Weinstein: Here's the reason that I think that my friend is being too cautious. I would welcome it if you want to make a counter-argument here. I believe he is not recognizing the compounding effect of the prophylactic benefit of ivermectin with the therapeutic benefit. We're going to talk in a moment here about how valuable it might be as a prophylactic. This is not you tested positive and we give it to you quickly, this is you take it so you don't get it, right? If it is used prophylactically, the effect is so good that the number of people you actually have to treat therapeutically is very low, and they have a very good prognosis on ivermectin. The composite of those two things, I believe-
[00:58:22] Dr. Kory: You could eradicate, period.
[00:58:22] Dr. Weinstein: - is clearly enough to end the pandemic, and the benefit, very few people understand really what we're up against because they don't think about this in evolutionary terms, the longer we leave that bug out there, the longer it is transmitting between people, the greater the chance that it evolves into something we can't eradicate like seasonal influenza.
[00:58:42] Dr. Kory: There's no question. Thank you for bringing that. There's so much to talk about, Bret. We forgot to mention the prevention. I keep talking about treatment. We all recognize it's much better to not get sick, than to get sick and to have to treat. As a student of the evidence for ivermectin, just like I talked about, the sources are in three different buckets or four, the trials that I've studied, there are prevention trials. By the way, I've been instructed to use the word prevention and not prophylaxis because, apparently, a lot of people don't really understand. Maybe not your viewers, but they don't understand the word prophylactic. I've trained myself to use prevention. Maybe your viewers are next level.
[00:59:24] Dr. Weinstein: Prophylactic is too closely associated with condoms. Is that what's going on?
[00:59:28] Dr. Kory: Yes, it could be. [chuckles] They should think of it that way, then you'll know it's a prevention of something. For me, there's data for prevention, early outpatient treatment, and late-phase hospital critical. They're all astoundingly positive. The strongest evidence with the highest magnitude impact is the prevention trials. Now, I think we're up to 13 or 14. At the time that I wrote my paper, I think we had eight or nine. They're tremendous. They are absolutely lights out. My favorite trial is the Hector Carvalho who's a researcher down in Argentina, who's now a friend of mine. I love Hector. He's really interesting guy, and he's another one who's just fighting for good treatment. He did a study with his colleagues where they didn't do a randomized study, Bret, sorry. In a pandemic, they didn't randomize it, but they basically got 1,200 healthcare workers, high-risk people, and they asked them who would take the ivermectin. 788 took ivermectin once a week for 10 weeks, and then the other 407 didn't. Nobody got COVID in the 788 who took it weekly.
Now, there's a bunch of studies. Some are every two weeks, some are every month but all of them have single-digit risks of getting COVID. The ones that take once a week are 0%. Nobody got COVID if you took it once a week. The group who didn't take it at all in this high risk, 58% got sick. 58% got sick versus 0%.
[01:01:02] Dr. Weinstein: I'm no mathematician, but that seems like a big difference.
[01:01:03] Dr. Kory: 58-0. It's almost like one of those college football games. You have a Big Ten team that plays some little nobody, and it's like 58 to 0. It's not subtle.
[01:01:13] Dr. Weinstein: Well, it's infinitely different. 58% to 0% is infinitely different.
[01:01:19] Dr. Kory: Not randomized, Bret. Easy, easy.
[01:01:21] Dr. Weinstein: Damn, it's not evidence. The numbers are fooling us somehow because they're not randomized. There is reason. You are not a pipefitter. You're an ICU doctor with experience with this drug, thoroughly versed in the data that has been amassed in many different context, of many different types. You believe in your heart of hearts, that ivermectin alone, and it is not the only tool at our disposal here, but ivermectin alone is sufficient to end the pandemic if we deployed it widely enough, and well enough.
[01:01:57] Dr. Kory: There's not even a question. If it became part of systematic global public health policy, you could decimate the incidence, the mortality, morbidity and just the cases of ivermectin. Let me go back to India. India, again, another country that suddenly found themselves in a humanitarian crisis, the scale of which we don't really even know. Even in India, they know that their numbers are not reflecting the true magnitude of how many people are dying, and how many people are getting sick.
If you look at India, in that crisis, finally saw a crack in the wall, and they started to speak the word ivermectin. You actually had, I think it's the ICMR, Indian Council of Medical Researchers, which is one of their main public health bodies where a lot of the doctors look to, they included ivermectin in their treatment guideline during this crisis. Then another All India Institute of Medical Sciences, which is some of their best institutions, and the top one is the one in Delhi, they also included it.
Now, you actually had huge public health agencies incorporating ivermectin. Then some of the states in India went even further, and they did much more aggressive. The boldest, and one of the most uplifting moves was the Minister of Goa, the state of Goa in India. He actually said, every adult above the age of 18 takes 5 days of ivermectin, which is like, if I was the health minister of my state or country, that's what I would have done. When I saw that, I could not believe that finally, someone was making the bold moves that were necessary to help these people.
If you look at Goa, there's a few states, Uttar Pradesh, now you're having a natural experiment, every one of those states, the curves are now precipitously declining. You're not hearing doom and gloom out of there, but there's a state in India called Tamil Nadu, whose minister there basically, effectively outlawed ivermectin and went all-in on remdesivir, bought a whole bunch of remdesivir. The cases and deaths in that state are skyrocketing. I don't know why. But his name is M. K. Stalin. I just have to mention that. Stalin in India outlawed ivermectin, and it's not going well for the citizens there.
[01:04:20] Dr. Weinstein: I hope this isn't too much inside baseball, but in order to understand an impossible to understand story like this, you need a way in somewhere. This is a couple of facts, as I understand them. The cost for a treatment of ivermectin is--?
[01:04:42] Dr. Kory: Negligible.
[01:04:43] Dr. Weinstein: I've seen the range from $3 to $12. For remdesivir, a new drug, still very much under patent, still very much paying the bills for its development, $3,000 a treatment?
[01:05:00] Dr. Kory: $3,000.
[01:05:01] Dr. Weinstein: Okay. That might begin to point in the direction of that object with immense gravity, that is acting against distribution of simple information about the effectiveness of ivermectin.
[01:05:16] Dr. Kory: There's no question. Again, going back to the problem, when you look at what is being recommended to treat this disease, it's deplorable. There's not a lot of consistency on how they made recommendations. The evidence for remdesivir is completely suspect. It's very weak and it's not even consistent, the WHO doesn't recommend it. The NIH does.
Now giving an antiviral in the hospital, days and days and days into an illness, the one thing we know about antivirals is they're really only effective when you give it upon first symptom. We're spending $3,000 a dose on a drug day 8 or 9 into an illness. The return on that is abysmal. It's not a very effective drug, but yet, that is our standard of care in this country, and so that problem is they're artificially limiting, and how they arrive at these treatment recommendations are absurd. It's clear it's because we are vulnerable. Our system is vulnerable.
It's a system where the voices that get heard are those with lots of money behind them. Those shiny trials that they put forth, those are the ones that get listened to, and those are the ones that get recommended. We're in a system where we're completely beholden to those with financial interests. A little drug like ivermectin, which has no-- its off patent. It's manufactured throughout the world. No one's making money off of it, that doesn't get heard. There's no voice. There's no force that is in the halls of the NIH that can put forth that.
Now, that's the kindest description of what I think is going on with ivermectin. Certainly, it doesn't have a proponent, but then we also can talk, it has opponents. A lack of a proponent, and it's up against the most, the deepest, and the most powerful opponents that you can imagine.
[01:07:10] Dr. Weinstein: All of them. You can't go up against the officialdom of the WHO and the CDC with the backing of every social media platform. If Silicon Valley lines up with the halls of government against a treatment, the battle is so Herculean, it's almost unimaginable.
[01:07:33] Dr. Kory: The YouTube, the censorship is their weapon. They're not the opponent. It's how they're fighting against ivermectin, but the opponents and I don't like talking about it, but I wrote a white paper, it's on our website, which is getting a lot of attention. I basically list the opposition. Those that would lose financially by ivermectin becoming the standard of care. Number one, is the entire global vaccination policy would be kneecapped. The EUAs would probably be revoked, if you had an effective, preventive, as well as treatment option.
[01:08:14] Dr. Weinstein: If the rules by which they were granted were enforced.
[01:08:18] Dr. Kory: That's a better way to say it, yes.
[01:08:20] Dr. Weinstein: No guarantee that that would happen given the kind of power arrayed against these things.
[01:08:25] Dr. Kory: Naive again? Is that what you're calling me?
[01:08:29] Dr. Weinstein: That's what happened. They never would have been granted in the first place, and they would have to be revoked now, and for very good reason.
[01:08:37] Dr. Kory: If the rules that they laid out were enforced. I definitely have to remember to say that because you're right, it would not necessarily happen.
[01:08:47] Dr. Weinstein: The rules, just so the listeners can follow along, the rules say that you can't grant this unusual authorization because of the hazard that it carries with it if there is a safe and effective treatment available.
[01:09:02] Dr. Kory: Correct.
[01:09:02] Dr. Weinstein: If there are two things that the ivermectin treatment appears to be, it's safe and effective. Not only safe and effective, but a prophylactic. It does a job that the vaccines do. There is no basis to grant the emergency use authorization. I would also point out, as long as we're here, that there is something so bizarre about the fact that the challenge to ivermectin is not that it is a terrible drug, it is that the evidence for it is not strong enough, right?
[01:09:36] Dr. Kory: That's what they claim.
[01:09:37] Dr. Weinstein: I think this is bullshit.
[01:09:38] Dr. Kory: Of course, it's bullshit.
[01:09:39] Dr. Weinstein: Even if it was true, the emergency use authorization effectively allows vaccines a very low standard that they have to meet because this is an emergency and we have to get them out immediately.
[01:09:52] Dr. Kory: The bar was set a little bit low, Bret. Is that what you're saying for the vaccine? So they could leap over and become massively used and distributed throughout the world.
[01:10:01] Dr. Weinstein: Right, and they are a marvel, I must say, technologically speaking, but at the same time, you're setting the bar for them exceedingly low because this is an emergency. In the very same emergency, setting the bar incredibly high, in fact, impossibly high for a drug that is already well-known to be safe. Therefore, the risks of actually taking a gamble on it are very small.
It is inconsistent, at the very least, to apply the low standard to the one and the high standard to the other. If you were going to do it, if you were going to have a double standard, it should go the other way, because ivermectin, the risk of harming a patient with it is so low. Whereas, we don't know, at a long-term level, we do not know what happens with the vaccines.
[01:10:42] Dr. Kory: I'm picturing it might. The imagery that's coming to mind is the giants of the vaccine industry stepping over like a little bar, and then there's like little ivermectin, who's like trying to leap up. Who's setting that system? That's the question. They're setting the bar here and here. There's got to be a reason behind it now.
[01:11:06] Dr. Weinstein: There is. I always am cautious in this place in a conversation, because we can detect that there's a gargantuan, something that is exerting gargantuan force in the space. We can infer that it has something to do with the financial incentives surrounding remdesivir, for example, the vaccine campaign.
[01:11:30] Dr. Kory: All the pipeline molecules, the stuff that's coming that they want to bring to market are also there, right?
[01:11:36] Dr. Weinstein: Which have had a tremendous investment made in them. The question, the thing that I think we are almost certain to get wrong, is that as outsiders, we have no idea what these conversations sound like on the inside. There is a temptation to imagine that people are somehow sitting around, comfortable with the fact that their behavior is going to cause hundreds of thousands, possibly millions of deaths, that it may stick humanity with a relationship with a pathogen that it will not be able to shake, because it will prevent us from taking the appropriate action until it's too late.
We imagine that people are saying these things out loud, when I am sure that there are some sociopath's in the system who are probably capable of having those discussions, but there aren't enough sociopaths to account for this behavior. There is some way that people who are doing a harm great enough, I have called it the crime of the century, and I realize the century is young, but this is going to be hard to top. It's going to be hard to top. There is some way that people who are engaged in something worthy of a claim like crime of the century, are comfortable with what they are doing or worse, are convinced that it is the right thing, that somehow the greater good is being served.
[01:12:58] Dr. Kory: I do think that there's some sociopaths that are exerting this, or just, they're able to-- here's the most magnanimous I can be. I definitely see intellectual laziness is driving this. Some of this is benign neglect, much of it occurring across the professional medicine. A lot of doctors are just parroting what they're told, is that the evidence is insufficient, poor trial, small, and nobody's critically looking at it. Even public health agencies, I think, are also guilty of that, of not exerting, and spending the resources that they should, critically examining this.
That's the kindest I can be, but I also think that there are forces. For instance, what I believe that happened at the WHO, is I believe that committee was told, that had to do the most recent review on ivermectin, they were basically told that they can't come out of that room with a recommendation for ivermectin. Let's say the motivation, so that the most sinister would be, at great cost of lives, so people could make money. That would be a very sinister one. A much more one that I think is, you could almost argue, might be reasonable, is that I do think there are people who are so convinced that vaccines are the answer to this, and that goal needs to be achieved at all costs, which is mass vaccination.
They see ivermectin as disrupting that. Maybe they have some greater public health goal, and that is how they rationalize what they're doing. That's the kindest I can be. That's the kindest I can be, is that they're doing it with good intention. The road to--
[01:14:39] Dr. Weinstein: They do, but they are doing without logic. Heather I have been making the point on the DarkHorse livestreams that the goal of getting-- to the extent that one is a believer in the vaccines believes that they are very, very safe, that there will not be long-term harms, that the key is to get so many people vaccinated that COVID goes extinct, right? I believe people really think that.
[01:15:06] Dr. Kory: I do too.
[01:15:07] Dr. Weinstein: I don't think they're worried enough about what we don't know about the long term.
[01:15:10] Dr. Kory: Agreed.
[01:15:11] Dr. Weinstein: Frankly, I don't think they're worried enough about what shows up with respect to short-term stuff, but let's just say, that that was their perspective. They are not thinking well, because what one needs in order to defeat COVID, is lots and lots of people who are not susceptible to it. There are really three categories of people who are not susceptible to it, right? There are people who have taken the vaccine, who are highly protected, though not from variants.
[01:15:37] Dr. Kory: For now.
[01:15:37] Dr. Weinstein: Right, for now. There are people who have had COVID, who appear to be as protected as people who have had the vaccine, as I understand the evidence, and people on ivermectin, right? All you need is for those three groups to add up to herd immunity in order for COVID to go extinct. To the extent that people are having the sense that they are the good people because they are pushing the vaccine thing so hard that everybody will have to get it, and they will strong-arm us if they must, those people are not understanding that the goal, which is laudable, which is herd immunity, can be achieved with a composite of types of immunity.
I will also say, there are two facts about the way we deal with COVID that to me stand out like a sore thumb. They tell me that this is not about good medical advice, right? That something is about something more important than good medical advice. One of them is that we are insisting that people who have had COVID get the vaccine, right? Now, to me, I'm focused on the fact that I know very well, we cannot know anything about the long-term consequences.
I know that the human immune system is a complex one, and that interfacing with it, potentially has consequences that will surprise us, and that we will not know for decades what the effect of this thing is, and that these technologies have only existed for less than a year, so we cannot possibly imagine ourselves experts in terms of the long-term impact of these vaccines. To take people--
[01:17:13] Dr. Kory: That is very disturbing. I just want to emphasize that point you just made. The fact that they're insisting that everyone get vaccinated, whether you've had it or not, it's extremely disturbing because it's all downside. You're only exposing them to the risks of the vaccine without the benefits. How can you credibly do that? The doctors that I know and trust, in fact, in our group, one of the doctors who helped us form, Dr. Keith Berkowitz, he's an internist in Manhattan. He does not allow his patients to get vaccinated unless they've been tested for antibodies. If they have antibodies, he tells them not to get vaccinated. That's good medicine.
[01:17:52] Dr. Weinstein: Right. No, it makes no sense. You have to imagine that the long-term downsides are inherently zero in order to even justify the stupidity of vaccinating. I mean, you don't even have enough vaccine. If your idea was to vaccinate everybody, you should at least economize on the vaccine even if the long-term risk were zero.
[01:18:09] Dr. Kory: You're again making too much sense.
[01:18:11] Dr. Weinstein: Yes, sorry about that.
[01:18:12] Dr. Kory: I mean, we could go all day in all of those areas where things just, just on the face of it, just on paper, make very little sense. Then, we all know about antibody enhancements. That's been known for coronavirus vaccine attempts in history. If you give it to those who've gotten it before, they get the sickest. I think people are getting harmed without a more sensible approach to this.
[01:18:40] Dr. Weinstein: A medical system that claims to be analyzing the evidence, and figuring out what's best, and then is acting in an authoritarian fashion, and telling doctors what to do, when-- I'm not a doctor, I can figure out they're screwing this up, right? That tells you that this is about something else. The other thing that tells you that this is about something else I think, is this policy that we don't treat you until you need help, until you're in dire straits. The idea of sending people with COVID home, and then seeing if they get sick enough.
[01:19:15] Dr. Kory: Until they turn blue.
[01:19:16] Dr. Weinstein: Right, but the point is if your point, and I think it should be all of our point, if your point is really actually, let us end the pandemic at any reasonable cost, right? If that's the point, sending people home is propagating the pandemic, and treating them late when you have a drug that would fix them early is malpractice.
[01:19:36] Dr. Kory: The only way in which that's sensible, Bret, is the studies using ivermectin is prevention. There was two types of study designs. One, where they prophylax healthcare workers. The other, which I thought was brilliant, is that anyone who tested positive, they immediately gave ivermectin to the household. They found in the households that took ivermectin, you could protect the household to a great extent. Now, the studies weren't perfect because, by the time you got them ivermectin, they had already been around their sick household members, so you can't prevent everything, but you could prevent that further risk of sending them home so you can send them home safely. If you had that, you should it safely.
[01:20:18] Dr. Weinstein: if you had that--
[01:20:19] Dr. Kory: If you had that, you could it safely.
[01:20:20] Dr. Weinstein: If you had a committee of clinicians figuring out what have we learned in the last week, and coming up with the update to standard of care every week based on what we actually know, you could do something like that, but what we're doing now, sending people home to get their relatives sick, and then treating them only when it's become an emergency, and they're not making that much virus at that point anyway, this is preposterous and insane. Those two things together just stand out. We are obviously willing to have many, many people die in order to accomplish some goal that has not been shared with us publicly.
[01:20:56] Dr. Kory: It's an obsessive focus with vaccines, and the other thing that I want to say about ivermectin is that the real shame-- that's an understatement, but we think of ivermectin. We need more than just vaccines. Even if the vaccines proved to be safe and long-term effective, you still need more. I like your model is that to really control the pandemic, you either need herd immunity by vaccination, prior exposure, or with ivermectin. Somehow, you got to get to whatever that number is, 90%, 80%.
We think of our information as that bridge. It's not only a bridge to that. For all of the areas of the world, which are not going to see a vaccine for a year or two, there's just not enough. For all of those who are vaccine-hesitant, you could safely, or contrary indicated, there are people who can't get the vaccines, they can now live safely with an alternative medicine. You could treat the vaccine-hesitant, the vaccine-contraindicated, or the vaccine poor, meaning those that won't get vaccines. It's another tool in the toolbox. We need more than just one horse to win this battle.
[01:22:06] Dr. Weinstein: We are hobbling to the extent that the vaccine effort is and effort to get to herd immunity, we are hobbling that effort by demonizing ivermectin.
[01:22:14] Dr. Kory: It's no question. Then so what the phrase that we like is that we consider it a bridge to and a safety net for. The other reason why it's a safety net is because of these escape variants. The idea that these vaccines are going to have long-term efficacy is not clear. They seem to be working quite well as far as on the efficacy side, the safety, I'll leave alone for now, but we don't know what it's going to look long-term. Ivermectin, on the other hand, is doing incredibly against all the variants. We know that in the areas of Brazil that did a concerted use of it, it was crushing the P.1 variant, especially if you use it early.
We knew it for doctors on the ground. There are cities in Brazil that used it. That totally, it is completely effective against the deadly P.1 in Brazil. The South African variant, which gave them fits a few months ago, that went to Zimbabwe. 60% to 90% of the cases in Zimbabwe, whether it's South African variant, they literally eradicated COVID using ivermectin in Zimbabwe.
We know it did well against South Africa, did well against the P.1, the UK variant, which went to Eastern Europe, Slovakia, and Czech Republic, they adopted international guidelines, cases and death counts plummeted. All of the variants, it has so many mechanisms of action. We still don't know all the mechanisms, and we're still not positive on what exactly the mechanisms are, but the ones that we think are, there's multiple, and they're not going to deal with-- the variants are not going to escape this. It has many tentacles.
[01:23:46] Dr. Weinstein: Okay. Let me unpack that a little bit. That's highly technical stuff. You have vaccines. All of the vaccines that are currently being used are narrowly focused on the spike protein. You've got a virus that has many proteins. You've got the spike protein as the most conspicuous target, and all of the vaccines are narrowly focused on it. This is actually unusual for vaccines. Many past vaccines have dealt with much larger fractions of the virus. This is part of how we got here so quickly to a vaccine that works, but what this means is that we are creating a very concentrated evolutionary pressure.
That to the extent that the virus can adapt, and become invisible to an immune system that has been primed with the spike protein, there is a selective advantage to those mutants, so we get escape mutants, right?
[01:24:38] Dr. Kory: That's how it works, yes.
[01:24:39] Dr. Weinstein: Now, you could imagine, and in fact, I wondered, whether or not ivermectin was going to suffer the same fate that effectively we were going to get resistance because, like an antibiotic, it is having some action, and to the extent that there are variants that aren't susceptible, they have an advantage but what you're telling me is that. actually, empirically speaking, if nothing else, whether we know the mechanism or not empirically speaking, the variants do not appear to escape ivermectin. They do appear to escape vaccines.
[01:25:10] Dr. Kory: You know what, Bret? I get to use what they always use. There's no evidence, there's insufficient evidence to show that ivermectin doesn't work against the variants. In fact, it shows that it does work against the variants. That's a very common question we get, and we had concerns. We didn't have the data, but from everything that we see, it works in India. In India, like I talked about, the states in India are absolutely decimating it. It's working against the Indian variant.
The one question that we're debating that I debate with Paul is, and where we're hearing from other doctors, and also from the trials, is that the dose is really important. We're thinking that with some of the variants, you need higher doses or longer durations. That's the only question, but the efficacy is still there. It just, we think that you need higher doses, and really the efficacy of ivermectin, like almost any other medicine in an acute illness, it's about timing.
You can probably get away with lower doses and short durations if you take it upon first symptom. Going back to my cupboard analogy, where I want every household in the country to have a bottle in the cupboard to take really upon first symptoms, even before. In fact, one Indian doctor who wrote us, he had not a test and treat strategy, a treat and test strategy, which I think is even better. Treat, then test, see if you know what you're treating. I think that's early is key, but later on, you need higher doses and longer durations is what we're finding.
[01:26:43] Dr. Weinstein: Okay. This raises some questions. On your website, there is a PDF document that very clearly lays out the protocol. It lays out the protocol, it lays out the dosage of some auxiliary supplements and things.
[01:27:03] Dr. Kory: Yes, exactly, that we think are either synergistic or will fortify and give you the best chance of beating this. There's lots of good physiologic rationale and excellent safety data around it. It's just good medicine.
[01:27:14] Dr. Weinstein: Right. Think like vitamin D. Vitamin D has very clearly been a predictor of whether you go sick and how sick you get from the beginning of this. It's something we've talked about extensively on DarkHorse. Therefore, sunlight is an excellent thing to encounter, and supplementing with vitamin D makes sense, too. Anyway, in your protocol document, there's a question about what, depending upon what, your protocol document describes basically what to do in the case that you have been exposed. That is not the same thing as what to do if you haven't been exposed, but you're going to use this in lieu of a vaccine, for example.
[01:28:00] Dr. Kory: Right, we have three, three approaches. One is what we call chronic prevention for the high-risk individual. We advocate that if you haven't gotten vaccinated, and you're at high-risk, which is, and who knows what that cutoff, that's why we just say high-risk. We know what the risk factors are, right? Age, obesity, race, African American, Hispanic, comorbidities, any confluence of those.
I don't even know what the cutoff is. Anyone over 30, I think, would be reasonable and/or comorbidities, maybe 40. It would be reasonable to take it as a chronic prevention. That's once weekly. The other thing I wanted to mention about our protocols, which is really important is that we are data-driven. We are humble to say that we are learning, we're trying to figure out the most, and we've always evolved our protocols. Everything in our hospital protocol, we got right at the beginning, but we have adapted timing of initiation and doses at times.
Same thing with ivermectin, we've changed the frequency, and we've changed the dosing strategies as more data comes out, but chronic prevention, we now moved it to once weekly. Then we have post-exposure prevention. Which is someone gets sick, the kid, the wife, the husband, whatever, it's for the rest of the family who were exposed. They all take basically two doses, separated out by 48 hours. Then the treatment, which is you take it upon as soon as you can, we say five days, or until recovery because some patients, if you start late, that five days is not enough. We also have a dose range. We moved our doses now to early mild disease, 0.2 to 0.4 milligrams per kilogram, and then in the hospital.
[01:29:39] Dr. Weinstein: Milligrams of ivermectin per kilogram body weight.
[01:29:41] Dr. Kory: 0.2 per kilogram. It's easy to calculate, but you have to calculate that out, and then we have higher dose ranges for the hospitalized patients. In our protocol, we also recently added another drug, which is also being ignored. Widely available, off patent, it's called fluvoxamine, it's an SSRI. It's an anti-depressant, which has these profound anti-inflammatory properties.
In the studies, both observational and randomized that have come out, it's showing to be highly effective. We've added that for the more severe cases, or the incomplete responses to ivermectin. Again, the later you treat, this disease is very complex. It has a number of different process. You got to hit it from a few different angles, and so we have, and if you look at our hospital protocol, we have many, many different medicines that are used in combination.
[01:30:37] Dr. Weinstein: I would just caution people. Ivermectin seems very safe and does not have side effects, to a large extent. Fluvoxamine, and you also have, and I've seen the data on this one, too, melatonin is an effective treatment. However, the dosages that you guys recommend are so high, they would have profound implications for people's sleep pattern.
[01:31:09] Dr. Kory: Well, fluvoxamine's not. It's actually a quite low dose. We're doing 50, twice a day.
[01:31:13] Dr. Weinstein: I was talking about melatonin. Fluvoxamine will have, presumably some SSRI effects. You shouldn't get involved in that unless you're really sick with COVID.
[01:31:22] Dr. Kory: Yes, but we try to have a reserve. If you're failing, starting late. So far in the trials, it's only a short term. It's not a long-term therapy where you run into possible adverse effects of chronic therapy. It seems to be really quite well-tolerated. Melatonin has no toxic dose. You could take a barrel of it.
[01:31:43] Dr. Weinstein: It's not a question of you're toxic, it's a question of whether you're coming out of it.
[01:31:47] Dr. Kory: Yes, exactly. We generally say to take that at night. Yes, again, everything is about risk-benefit, and so you use these medicines depending on the condition. The sicker the patient, the more the risk-benefit ratio of these things changes.
[01:32:06] Dr. Weinstein: If somebody's sick, you can afford to disrupt their sleep, and you're disrupting it in the right direction. In general, people have trouble sleeping in the hospital.
[01:32:14] Dr. Kory: It's not the worst thing to get a decent night's sleep, right?
[01:32:16] Dr. Weinstein: Right, exactly. All right. I do think we blew right by some of the discussion of vaccines, and I do want to just get us to be clear about this so everyone understands. I am increasingly annoyed at the moniker anti-vax, because I feel it's being used as a weapon. I've had it directed at me. I am not anti-vax, whatever that means, and I'm also not anti-vaccine. As a matter of fact, I'm very pro-vaccine. I think it's one of the greatest tools in our medical toolkit, and is responsible for a tremendous amount of good, the ability to vaccinate.
I am vaccinated against some things that almost nobody is. I'm vaccinated against rabies, for example. My history as a mammologist had me handling animals that almost never had rabies, but it wasn't-- rabies is such a terrible disease that it was worth getting vaccinated. I'm a pro-vaccine guy, and to the extent that I'm hesitant about these vaccines, it's about the massive unknowns and that was true, originally, and it is now about the evidence that there's actual short-term hazards here, too. It's not just the long-term unknowns, it's the emerging picture.
[01:33:30] Dr. Kory: It's just science, right? We're looking at data and we're just-- but that goes back to that authoritarianism, which we're being told how to treat, and what to think, and what to say. You're basically taking away normal scientific discourse. I guess you can't really do science on social media because you're not allowed.
[01:33:53] Dr. Weinstein: Well, you could if social media--
[01:33:55] Dr. Kory: If the gods of science knowledge tell you you can talk about it, then you can.
[01:33:59] Dr. Weinstein: Right, you can't do it in this environment. It's too perilous. Let's just say, to the extent that we need to be able to say in a pandemic situation, that this vaccine is safe, that means we have to be able to discuss it when it isn't. To the extent that it is automatic that we will say it is safe, nobody is going to trust it. The ability to discuss how safe it is or isn't is essential. I just want to cover this for you as well. You're not an anti-vaccine person.
[01:34:31] Dr. Kory: No, no, not at all. No, I'm fully vaccinated, so are my kids. Not this vaccine, because I have an alternative that I am much more comfortable with, personally. I use ivermectin. Again, I want to see more data on these vaccines and it's-- I don't know, I just feel it's a reasonable clinical benefit. That's all.
[01:34:51] Dr. Weinstein: Well, let's go back to the Argentina study that you talked about, where it was like 58% in the one group got it, and the ivermectin-treated group, 0 got it. How good is the protection from ivermectin? The answer is, it appears to be absolutely, stunningly excellent. How good is the protection from the vaccines? It's pretty darn good, but it's not 100%. In any case, from the point of view of how safe are you, I agree, it's the better treatment.
[01:35:26] Dr. Kory: Some people will say, "Oh, but you got to take it every week and how long are you going to take it for?" We have no evidence to show that it's harmful. It's well-tolerated and it's cheap, it's safe. I'll take it as long as this pandemic's out of control. I think, like you said, it's that model, if we can get to herd immunity using all the tools at our disposal, you're going to get incidence rates that are so low that you don't need to take in anymore. I think that's achievable. I really do think that's achievable.
[01:35:56] Dr. Weinstein: If we can get past the campaign to prevent us from talking about it. I actually wanted to ask you about this, too. Some of the really interesting evidence from what we would call a natural experiment, comes from the fact that people were taking ivermectin in Africa, as you point out, for its anti-parasitic properties, and that that appears to have given them protection from COVID when it happens. The prediction is that Africa was in huge trouble, did not manifest, and the circumstantial evidence points to ivermectin.
What I didn't know, until you told me, was that the dosages involved in the anti-parasitic treatments, they may be high dosages, but they're very infrequent. The fact that that produced substantial enough immunity to COVID that it could be detected suggested actually, this is a very potent and effective treatment, I mean preventive.
[01:36:55] Dr. Kory: The group that wrote the paper that did the analysis on Africa, it's a really interesting paper, they say in their introduction that they saw the signal, they saw the discord or disparity, very early on, but they didn't want to publish yet, because they wanted to just watch this play out. Once the data became overwhelming, they published their paper. What they did is, they were able to look at which countries in Africa had distribution programs for parasites. They just looked at all of the countries with it, and all those without it. The degree of statistical significance approached zero, like the P value was zero. The probability that--
[01:37:36] Dr. Weinstein: Chances that this is random is zero.
[01:37:38] Dr. Kory: Was zero. This is as real as it gets. If you live in a country which had, like you said, even as infrequent as twice a year, you had much lower cases and deaths from-- when you put together all the piles of evidence that are screaming that ivermectin can demolish this pandemic, that's just another one. My favorite is the little one, which is the nursing home.
ivermectin is a treatment for scabies. What happens in nursing homes is, if one resident gets scabies, all the residents take it. It's almost like if one resident gets the flu, they give Tamiflu to all the other. They give it to all the other residents, as well as the workers. A French nursing home, when they were all getting decimated, all their elderly people were dying, a nursing home in France had a little outbreak last March of scabies.
They gave everyone ivermectin. They noticed that in the region's nursing homes where the deaths were 5% to 10% of all residents, the case counts were 22%, they noticed in this one nursing home with the scabies outbreak that nobody died, and very few got sick. That's been described in multiple nursing homes where they've had scabies. They noticed that COVID tends to not be there. You’re seeing it in all of these different facets. It's phenomenal stories.
[01:39:06] Dr. Weinstein: This is what you would expect actually if this drug was for real. You would expect. This is more like what happens in ecology and evolution, where if something is true, then you can just think, "Well, if that were true, then I would expect to see it here and not there."
[01:39:21] Dr. Kory: It's true everywhere.
[01:39:23] Dr. Weinstein: Then you go out in nature and lo and behold, the pattern that you're looking for is there. Every place that you would expect this, you see it. That's an amazing fact, and it is a very powerful kind of evidence in and of itself, the fact that every type of evidence tells the same story.
[01:39:40] Dr. Kory: Paul says this, I think I said it first, but I think he's claiming it as his original statement, but I've said that if you are going to have-- I just want to just say a couple of things that I like to say about ivermectin, is that knowing what we know about this disease and that it's a viral replicative phase and that it's a severe unchecked inflammation later on is that if you're going to design a drug to treat COVID, you wouldn't want something that works as an antiviral and an anti-inflammatory. Like I mentioned before, we have multiple mechanisms that we think it's acting as an antiviral, but also there's a body of studies showing that it really works at controlling or modulating inflammation. It works in all phases of the disease. The other thing that you want, is you'd want it to be safe.
The one statement I like to make about safety is that a recent review was done by a world-famous French toxicologist. He looked at 350 studies and reports on ivermectin to get the most accurate safety profile of the medicine. In his executive summary of the paper, he wrote that severe adverse events are unequivocally and exceedingly rare. It is an extremely safe medicine. There's not a lot of medicines you can say about that, that unequivocally and exceedingly rare.
If you wanted a drug, you'd want an antiviral and anti-inflammatory, and then as a bonus, you might want something that prevents the virus from getting in the cell. You'd want it to be a preventive, but that's probably asking too much.
[01:41:13] Dr. Weinstein: It's too much.
[01:41:14] Dr. Kory: It really.
[01:41:15] Dr. Weinstein: Come on, be reasonable, Pierre. This particular drug happens to bind the spikes protein and prevent the virus from getting in the cell.
[01:41:23] Dr. Kory: Literally, I think Paul did say this, but it's really a gift to us. It really does give me tingles, to think of that we have this medicine that does exactly what we needed to do to get out of this hell, for the world to get out of the hell.
[01:41:41] Dr. Weinstein: To get out of the hell.
[01:41:44] Dr. Kory: We're not the point.
[01:41:45] Dr. Weinstein: We've talked about the medical consequences. We have not talked about the crashing of the normal functioning of planet Earth. The idea that we wouldn't deploy this is absolutely maddening, which just so that I don't forget to say it, I'm going to come back to what may be going on with this story in the pharmaceutical industry.
If it is true that something in the neighborhood of what we have suggested about the financial incentives surrounding remdesivir and vaccines and the campaign to deploy them, if something like that is the object exerting this gravity, making the story not add up and result in massive amounts of death and misery and damage to humans that will be manifest for decades to come, if that's what's going on, and this really is about the investment that has been made in these exotic drugs and vaccines, we should be prepared, civilization should be prepared to buy out their interests.
If this was wartime, and this is something of the scale of a war. If this was wartime, we would not hesitate to say that factory in which you make those things it's making weapons now, and we are going to go fight the enemy. I'm sorry that that's going to get in the way of your profits, but this is your duty to participate on our team. If that's what we have to do, if we have to commandeer these things and buy out their interest so they will let us do it because this isn't technically a war, then we should do it.
It will be cheap compared to the immense, we're talking about trillions of dollars of loss. It might be hundreds of billions of dollars of profit, it is trillions of dollars of loss to planet Earth, and the amount of human suffering is incalculable.
[01:43:28] Dr. Kory: I haven't heard of that buyout idea. That's pretty fascinating.
[01:43:32] Dr. Weinstein: I hate it.
[01:43:33] Dr. Kory: It's disgusting, but like I said, whatever it takes. I can't bring up that war metaphor enough. We've said it since the beginning, we are literally acting as if we're, or the FLCCC, we're a rapidly deployed force, the five of us, actually, there's more of us now but we have done the work that the agency should have. We've reviewed all the evidence. We've compiled all of this.
We did the stuff that the army and the public health agent should have done. Again, the reasons for why they didn't go from the benign to the sinister. I want to call attention to we and the arguments that we make for our treatments is that we're at war and they're playing peacetime here. They're using peacetime rules when we're at war and it's insane.
[01:44:21] Dr. Weinstein: Well, no, that's not what they're doing. I hate to correct you but here's what's going on.
[01:44:26] Dr. Kory: They're pretending to.
[01:44:27] Dr. Weinstein: They are having us behave as if we are at war while they are playing business as usual.
[01:44:33] Dr. Kory: True. That is better said than--
[01:44:36] Dr. Weinstein: This is driving me crazy because the point is they actually have us at each other's throats about whether or not we're wearing our masks outside and whether or not we're vaccinated or not, and that is the dictator of whether or not we are good people, and this is bullshit. I'm as protected with ivermectin as you are with your vaccine, and I'm not talking about you, I'm talking about you, person X.
There's no basis on which you can wag your finger at me. I'm not putting people at more risk than you are, right?
[01:45:01] Dr. Kory: Yes.
[01:45:02] Dr. Weinstein: Why do they have us at each others' throats if they are going to continue to play this game about profit, which appears to be the only explanation that could possibly tell us how do they not respond to an overwhelming quantity of data that a gift, a drug that is actually a gift. A drug that does not have to exist. It doesn't have to be a drug that's this good, but to turn down that drug on the basis of other things which don't have the safety profile, don't have the effectiveness is-
[01:45:35] Dr. Kory: It's indefensible.
[01:45:36] Dr. Weinstein: -it's indefensible. They're clearly playing a business game while they have us in a war posture.
[01:45:41] Dr. Kory: It's indefensible.
[01:45:43] Dr. Weinstein: It's preposterous.
[01:45:44] Dr. Kory: Bret, I don't want to change the topic, but there is something else because, again, I just find it-- Again, I'm just very grateful to you, and I think we, as a group of committed clinicians who really are just acting on our oath and we're trying to just advocate for good sound medicine and effective treatment, we haven't been given a voice. We definitely have a lot of followers. We've had tremendous success around the world, but in the United States, exactly no one's heard of ivermectin in a credible way.
Coming on your show we hope is a march to having that in the wider consciousness, not only providers, but patients. I think that's really important. The one thing that I want to mention before I forget, because there's another area in which we're failing at treatment and I find it not as egregious as the ivermectin, but the corticosteroid issue that when we came out and recommended it, six to eight weeks later, Oxford did the RECOVERY trial which proved to the world that steroids were life-saving. To say that we said we told you so, we got past that.
Here's the travesty of it, is the Oxford trial used this tiny dose of corticosteroids. They used a dose lower than what I give my 80-year old patients with emphysema when they get a little sick, I give a higher dose to them. They're giving this tiny dose to people crashing on ventilators with horrifically inflamed lungs. If you're only talking like what's sensible, and they also give it for a time limit, they give it for 10 days as if the disease has been determined to last for 10 days. There's nothing that makes sense.
We know that higher doses are needed. We know that longer durations are needed. There's no research going on into looking at other protocols. The entire world, this country, every doctor, every sheep of a doctor in this country is following remdesivir, 6 milligrams of dexamethasone. Literally in all the health systems are telling them this is what you should use. If you use a higher dose, you're off protocol. In some places, you're probably going to get feedback for that.
I use very aggressive dosing strategies for longer durations. I think there are quite a few doctors who are, but the official NIH one is this tiny dose of steroids. That dose, and I can assure you I have tons of data, it helps the few and fails the many. There are many, many patients dying in hospitals of inadequate treatment of this disease with an anemic dose of steroids. Just to add it to the list of stuff that doesn't make sense.
[01:48:19] Dr. Weinstein: I was just going to say, what this is, is it is more evidence of a gravitational force from an object we cannot see.
[01:48:25] Dr. Kory: That one, I don't know if that's a sinister. That one is just stupid. That's just unfit. I just don't know where are all the doctors here who are saying what like I'm saying, which is the dose of steroids doesn't work. I've now published 10 papers on COVID. The one that I think is the most impactful, the ivermectin is probably pretty huge, but myself and one of the top chest radiologists in the country if not the world, we wrote a paper saying that this disease is actually not a viral pneumonia, it's an organized pneumonia.
The mainstay of therapy for organizing pneumonias which is a non-infectious pneumonia is corticosteroids. In fulmen in cases we know over the decades in treating you need high-dose steroids. Nobody's paying attention. They're still treating this with this little anemic dose. It's bizarre.
[01:49:12] Dr. Weinstein: The obvious thing to do, were I a clinician, and you tell me if I misunderstand what doctoring is about, but were I a clinician, I would be tempted to the extent that there is some dose that I'm told is the right one, I would be tempted to see what happens a little higher, a little lower. Oh, the higher works, a little higher. You would find whatever dose worked best at the point that you just nudged it a bit, right?
[01:49:36] Dr. Kory: Yes.
[01:49:37] Dr. Weinstein: The idea that there's some God-given dose is absurd.
[01:49:40] Dr. Kory: The God-given dose is what was tested in the trial, and that's where I find randomized trials it's another reason why they're very unsatisfying because they tested one protocol.
[01:49:48] Dr. Weinstein: One thing, right.
[01:49:50] Dr. Kory: It doesn't mean that's the only one, but the world is taking as that's how you treat COVID.
[01:49:54] Dr. Weinstein: That is maddening.
[01:49:55] Dr. Kory: It's mad. The other thing is, what I know is my guess and I haven't talked to those investigators, but my guess as to why they tested such a low dose is because they were literally fearful that it was going to be harmful. They on purpose tested a low dose. I actually find that one of the greatest tragedies that we came very close to, is that trial ran the risk of being negative because it used such a low dose. The reason why it was a positive trial is because it was massive. When you have a huge trial, you can detect-
[01:50:29] Dr. Weinstein: The tiny weak signal.
[01:50:30] Dr. Kory: -small benefits. Had it not been a massive trial, it would have been a negative trial, and you know what we'd be still be doing? Tylenol and fluids. Oh, I'm sorry, remdesivir.
[01:50:42] Dr. Weinstein: This is fascinating. First of all, this is a feature of complex systems. The complex system is very sensitive because there's so many inputs to it. The idea that you could have two lower dose, you could convince yourself that this drug, you came into it, people were telling you, this drug will be harmful. They didn't test a very high dose, they could have tested so low a dose, they wouldn't have seen the signal that it was beneficial, and we would still be telling ourselves it's harmful.
Instead, the dose was high enough to detect that it is beneficial so it is now the standard of care, but the standard of care is too low a dose because they tested one thing and people are afraid to depart from it because of I don't know what.
[01:51:22] Dr. Kory: Again, it's overlying on evidence and not expertise. Again, I mentioned one of our closest partners in the FLCCC is Umberto Meduri. He's the world expert at using corticosteroids in lung injuries. He's an intensive care physician who has been studying steroids for 30 years. Where's his seat at the table? Why aren't they asking him? He has a protocol, we follow his protocol. It's been born of decades of use. I just don't understand.
I made a joke once with my colleagues is that we really want-- you can have the NIH, the CDC, and then we want a building for the FLCCC. Just ask, what's the FLCCC? We'll tell you what we're doing on the frontlines to treat this disease while waiting for your big randomized control trials that you're in love with.
[01:52:15] Dr. Weinstein: Well, I know you're joking, and I know that you're not joking.
[01:52:17] Dr. Kory: Exactly.
[01:52:18] Dr. Weinstein: Obviously, the idea that in-- it's different if you're talking about a disease that has been treated for 50 years on which the treatment regimen has settled and maybe there's something that new comes along, but we can officially find out what that new thing is. This is a different case, everybody's a novice. Why aren't you clinicians at the table? That's preposterous.
[01:52:43] Dr. Kory: Why are they doing more trials on these? Why don't you test 6 milligrams of dexamethasone against a higher dose? No one's getting placebo. It's a reasonable thing to do it. I wouldn't go in that trial because I'd want the higher dose, but I think there's enough clinical equipoise amongst doctors that you could easily randomize people and you could find what the most effect-- Where is that effort?
[01:53:04] Dr. Weinstein: Because, obviously, it would save lives didn't know what the most effective dose is.
[01:53:07] Dr. Kory: Maybe COVID is not a problem. I guess they don't feel it's sufficient enough a problem to study this but-
[01:53:12] Dr. Weinstein: Right, we're on a war footing, but they're not taking as a priority. You blew by something here that I think is very important. You said that in the rest of the world, people are beginning to understand the ivermectin story, but in the US, effectively, nobody is doing that.
[01:53:29] Dr. Kory: I'm demoralized and what I've had to do to preserve myself, and what I do, because I'm getting killed here. When I'm being written about and my advocacy, it's crazy. I don't pay attention to it. I'm immensely saddened that all of the health systems, and I have colleagues and trainees who work in multiple systems, you can't prescribe ivermectin. One of the safest drugs known to man, even if you were convinced by my papers as well as the other independent panels, you can't even prescribe it to a patient in many hospitals in this country. The pharmacist will not give it to you because from on high, they're saying not to.
[01:54:08] Dr. Weinstein: Okay, so I want to put this in a slightly different context. I find that as maddening as you do, but I also find it maddening. We, Americans, botched the COVID crisis early on. Many people died who didn't need to because of the way we reacted. We're doing it again. Why should we be lagging the world in the understanding of the utility of this drug?
Why would we allow that to happen to ourselves? This is absolutely unpatriotic and it has to do, I think, with the fact that the corruption that we have is, in many ways, more pronounced, it is more effective, it is more deeply entrenched and it has access to more tools here than elsewhere.
[01:55:00] Dr. Kory: I agree.
[01:55:02] Dr. Weinstein: Somehow we, Americans, have to recognize that this story, as crazy as it is, is actually telling us something about an entirely different disease that has to do with the authoritarian control over thought about what is true, and that that manifests here in a medical context that is absolutely ghastly, but that is not its fundamental nature. Its fundamental nature is about controlling what people think for purposes that have something to do with profit.
[01:55:31] Dr. Kory: It's that control of why-- Going back to your question, the US you just can't get anyone to talk about ivermectin credibly. If you look at the big media outlets, so I'm waiting-- The Washington Post did a story but anytime-- There's been very few credible mentions. I did an interview with Washington Post and I knew what the article was going to say before. I knew it was going to be a he said, she said. Meaning every time they do it, they say Dr. Kory and his group says this, the NIH says that, and you're left with the NIH thinks-- It's nice that these doctors think it works, but the NIH doesn't. It doesn't lead you to anywhere good.
[01:56:13] Dr. Weinstein: It is designed to leave you without a conclusion.
[01:56:17] Dr. Kory: Clearly, or the conclusion is everyone who trusts the agencies know if it was working, the gods of science knowledge would say too, "These rabid doctors are just they're a little overexcited." The fact is there's not a discussion around ivermectin in major or mass media. The only times I get invited to do interview, it tends to be a right wing or conservative media because I think they're more naturally aligned to question government. That's the only places I can get a voice. No major central or liberal leaning outlets want to talk to us or give us a credible-
[01:56:56] Dr. Weinstein: No mainstream.
[01:56:56] Dr. Kory: Mainstream, that's what I meant.
[01:56:57] Dr. Weinstein: You're sitting here at the table of liberals, the heterodox liberal. It is the Orthodox Liberalism that is finding this impossible to swallow. Unfortunately, for reasons I cannot explain, that mainstream pseudo-leftism in the US has become aligned with all these gargantuan powers that it traditional it would have been opposed to.
[01:57:25] Dr. Kory: I thought that's what we were about. I'm a liberal as well.
[01:57:31] Dr. Weinstein: Well, of course. The thing is now we're rebels in the--
[01:57:33] Dr. Kory: "Heterodox" is a good word because it's true, I don't align perfectly with know everything that we're-- and what we're supposed to be about, I think we're failing. Anyway when I look at the US, we have a map, so it's been-- I got to tell you at the same time that I'm so demoralized what's happening in the US, when I look at all the countries that have and the amount of countries that have adopted into their national guidelines and are absolutely saving hundreds and thousands if not millions of lives with ivermectin, a lot of times our review paper and our group is mentioned, and it's extremely satisfying thing.
Even in India, in many states in South America, in Central America, even Mexico used our work as we brought it to attention of a lot of these agencies. When you look at Eastern Europe and Slovakia and Czech Republic it's so-- The impacts of Paul Merrick's early identification of ivermectin and our review paper, it's tremendous on a global scale. It's still insufficient, but it's tremendous.
The last thing I want to say is it's not just the FLCCC. My review paper, which just got published about six weeks ago, is one of now six published review papers all written by, and I have to stress this word, Bret, independent panels of experts, not allied with a university, a newspaper, a pharmaceutical company, just well-meaning academics who are looking at this evidence, and in those six reviews, so it's our group, a tremendous group from the UK headed by a woman named Tess Lawrie, she's actually an expert consultant to the WHO and the Cochrane library.
For a living you know what she does? She does systematic reviews and meta-analyses which informs treatment guidelines for all of the major areas agencies. She has done that, her and her group did this for ivermectin. You can't come up with a more credible sourcer. She also, her group, and they brought together a guideline committee of 65 people from all around all world, all advocate ivermectin. Satoshi Ōmura's group from Kitasato Institute in Japan, they did and published a review paper also calling for ivermectin-
[01:59:51] Dr. Weinstein: Nobel Laureate.
[01:59:52] Dr. Kory: -and a group of Italian researchers in Spain. You have independent panels from Spain, Italy, UK, US and Japan none of us with conflicts of interest, none of us who stand to gain anything, and we're all saying the science says this has to be systematically deployed. The fact that even with those credible voices from all of those countries, we're getting drowned out and we're just getting suppressed and distorted.
[02:00:18] Dr. Weinstein: There is no level of consistency among people who have looked at this. There is no amount of credential that breaks through this wall of silence. Am I correct, you are, in fact, the author of the major textbook on the use of ultrasound in point of care?
[02:00:43] Dr. Kory: My real, I guess, claim to fame within my specialty was I was one of the pioneers of a new field called Point of Care Ultrasound, which is really critical to use in ICUs. It allows us to detect life-threatening conditions within seconds. You don't need to call for a study, you can do it at 2:00 in the morning. I can look at a heart and I can know if the RV is blown, the LV is blown. I can tell if there's a hole in the lung, what's going on in the lungs, I can do that.
[02:01:09] Dr. Weinstein: Am I right that in part this is a special tool because not only does it allow you to look into the tissues, but it allows you to look into the tissues in motion?
[02:01:17] Dr. Kory: Oh, yes, you can detect any number of life-threatening conditions. I'm really proud, the textbook of which I'm a senior author, which I edited with a couple of really talented colleagues, it's one of the bestselling textbooks. It's now in seven languages. That's one of my proudest contributions to medicine before COVID. I'd like to think my role with the team and getting ivermectin into the language is going to be another big one, a lot bigger.
[02:01:46] Dr. Weinstein: I hate to even use this term. It's offensive to me that I should even voice it to you, but you're being dismissed as a crank despite the fact that you have the credentials, you have the evidence, you have a history of saving lives, of innovating and pioneering techniques. Not only that, but you have a history of improving the standard of care for this very disease, and yet you're dismissed.
[02:02:15] Dr. Kory: When I say me, let's look at the core five of us. Umberto Meduri, decades of research on corticosteroids. He also is one of the fathers of non-invasive ventilation. He did some of the first studies on those BiPAP and CPAP machines which we use in ICU's in lieu of endotracheal intubation. He's a giant in medicine, he's on the FLCCC. Paul has published any number of books and chapters and papers on so many different facets of critical care.
Paul's imprint on our specialty is huge. Joe Varon is one of the world experts in what's called therapeutic hypothermia where we cool people after cardiac arrest to protect their brains and promote brain healing.
[02:03:01] Dr. Weinstein: He saved my wife's father's life.
[02:03:04] Dr. Kory: He got cooled?
[02:03:05] Dr. Weinstein: He did.
[02:03:06] Dr. Kory: I'm also an expert. That was my first claim to fame in medicine because I got really interested as a fellow. I was one of the pioneers who developed protocols for all the hospitals in New York City. I'm from New York, that's where I trained. I was part of Project Hypothermia there. Joe Varon, he's published a lot and he's still doing lots of research on therapeutic hypothermia. When you look at our group, even before COVID, we had some of the biggest contributions to our fields in different ways, and yet, again, we're being ignored. We're not cranks.
[02:03:39] Dr. Weinstein: You're the opposite of cranks. Not only are you not cranks, you're the opposite of cranks, what my brother calls knarcs, which is cranks spelled backwards.
[02:03:50] Dr. Kory: Knarcs. [laughs]
[02:03:51] Dr. Weinstein: Right. The experts are being dismissed as cranks. Your testimony on this topic in front of Congress was taken down by YouTube, which I find another glaring fact of the story because who the hell are they? Even if you were a crank testifying to Congress, why is the public not allowed to see that? The fact that you're the opposite of a crank testifying on a matter of importance to all of us should have made this a very famous piece of testimony.
[02:04:25] Dr. Kory: You're not allowed to talk about ivermectin. It's in their community guidelines. It's not allowed.
[02:04:30] Dr. Weinstein: It's absolutely insane.
[02:04:32] Dr. Kory: You're not allowed.
[02:04:34] Dr. Weinstein: All right, I've got two more things on my agenda. You may have other things that you want to raise. I wanted to just deploy a little models. I'm trying to figure out what the object is with this immense gravity that we can detect but cannot see. I had the following thought. Somehow this question, as we've talked about, the vaccines and the fervor for the rollout, the insistence that everybody get it, whether it makes medical sense for them to get it or not, that is a very powerful indicator of something. Something that I believe is driving here.
It occurred to me, we did a little segment on DarkHorse, Heather and I did, on the difference between relative measures of effectiveness and absolute measures of effectiveness. This is a bit arcane, but the relative measure of effectiveness for something like these vaccines are very impressive, something like 95% for the two mRNA vaccines. That is when you compare people who got it with people who didn't get it, how much more protected were the people who got it? If you use an absolute measure, that is to say, how much good did you do the people who got it, the number plummets because the fact is not everybody confronts COVID-
[02:05:51] Dr. Kory: The actual number of people who were prevented from getting the infection is reasonably low.
[02:05:57] Dr. Weinstein: Reasonably low. The number of people you have to vaccinate to prevent an infection is pretty high.
[02:06:01] Dr. Kory: Number needed to treat, that's a common metric that we use.
[02:06:04] Dr. Weinstein: Right. Okay. In light of that, the thing about the absolute measure, which is much lower, is that it is actually sensitive to what alternatives you have.
[02:06:16] Dr. Kory: Yes.
[02:06:17] Dr. Weinstein: Ivermectin, for example, I believe, was specifically excluded from at least the Pfizer trial, and I would imagine, the others as well. The point is, you couldn't be in the trial if you were on it. The point is, you were comparing people who were vaccinated with people who were absolutely unprotected. Were you to compare people who were protected by ivermectin-
[02:06:37] Dr. Kory: Oh, my gosh.
[02:06:40] Dr. Weinstein: -the absolute measure of value would crater.
[02:06:45] Dr. Kory: You would also run the risk, Bret, of actually proving a superior efficacy of ivermectin. You can clearly come out with a trial which showed the ivermectin group got less infections than the vaccinated group. In my mind, if you gave it to them every week, you'd definitely find that.
[02:07:01] Dr. Weinstein: You'd find that. Okay, so then, here's what you've got. You've got the effectiveness in absolute terms, is very low and it craters to something like zero if compared to ivermectin. At the same time, what doesn't change is the risk of the vaccines, that is to say the long-term hazards. Let's leave the short-term hazards aside for the moment, though that may be significant. The long-term hazard is a total unknown.
The point is, how useful is it, how wise is it to take that long-term risk? Well, that answer is very different if you treat that question in isolation from ivermectin, or with the presence of ivermectin. In the presence of ivermectin, there is no justification for this at all, right? The point is, that suggests that this analysis about the emergency use authorization is not an abstraction, it may be absolutely central to this because you can't have ivermectin anywhere in the picture or the analysis becomes- [crosstalk]
[02:08:02] Dr. Kory: It's critical that ivermectin not be entered in to that equation. If you put ivermectin as a variable in that equation, you do not come out to a conclusion that the world should get rolled over with vaccines. That's not what the equation would show, the calculation, and I agree with that.
[02:08:20] Dr. Weinstein: What that means, and let's be as generous as possible here, were you a pharmaceutical exec and you've invested, I don't know, hundreds of millions of dollars in the generation of these vaccines at a time when ivermectin was not understood to be effective, and then ivermectin comes out of nowhere, it's not under patent, so it can be made cheaply, it is being made all over the world already. It's safe and effective. The point is, that's a nasty surprise because you may have invested money that you can't recoup because there's no justification for exposing people to the hazard-
[02:08:59] Dr. Kory: Some bets work out, some don't.
[02:09:01] Dr. Weinstein: Some bets work out, some don't. I would really hope that the pharmaceutical industry would understand that this was just the cost they paid.
[02:09:06] Dr. Kory: Take the loss.
[02:09:07] Dr. Weinstein: Well, you know. I mean, mom-and-pop shops paid a terrible price.
[02:09:11] Dr. Kory: Exactly.
[02:09:13] Dr. Weinstein: There was a lot of bad luck to go around here and nobody is entitled to be immune from bad luck, we've all got exposed to a certain amount of it. Even if we had to buy them out, that again, even if we had to buy them out, why are we exposing people to this risk if all we got to do is say, "Hey, we found a better solution, thank you for your service. Here's some payment to make you whole, and can we please go do the right medical thing?"
[02:09:36] Dr. Kory: Brilliant. I agree. I totally agree. You still shocked me with that buyout. I just don't know how credible that is. You're literally giving someone money. "Just step away from the table, we do not need you participating in the planning meetings anymore. Just go away."
[02:09:57] Dr. Weinstein: Right. The alternative is people are losing loved ones. That people are losing loved ones needlessly.
[02:10:03] Dr. Kory: One thing I haven't talked about yet is that when you see what happens to these people, those unfortunate few that actually get to the ICU and that match through those anemic doses, they're so sick and they're so hard to get better in the ICU. This disease is crazy. It's so unique amongst critical illnesses, because in my career what I find is when patients get really, really sick, they generally will adopt a trajectory.
Meaning within the first few hours a day, they will determine something. You'll see some stability and then a slow rise of improving of organ functions, or even the main organ that's failed, or you'll see some stability followed by unfortunately deteriorations to death. There's only two ways out of the ICU. Either you get discharged to the regular wards or you die because it's really the end of the line, and COVID is wicked. You get on these vents and the patients are like this for days to weeks.
We routinely take care of patients weeks and weeks on ventilators, which is one of the reasons why they were running out of ventilators because everybody was going on them, nobody was dying. They were dying, but it was after lengths of stays that we'd never seen before. You're still seeing it, and the amount of suffering and they're paralyzed and then we have to prone them so their faces swell, they get tissue injuries and they're in deep sedation.
Those that are lucky their lungs heal, they come out delirious and agitated and it's a wicked recovery. The mortality and morbidity it's really indescribable, and not that I've become immune to it, but I think a lot of us we're just so used to seeing it, but the suffering of these patients are crazy, and then add to it the visiting policies. They're all alone. The patients oftentimes will die alone, they fight alone, the families are calling on the phone.
Now they're liberalizing it for a while but I worked during the pandemic in New York/ I did a month of running my old ICU. We were Zooming with families. We'd put the little iPads next to the patients and they would look at their family members dying. It was terrible.
[02:12:26] Dr. Weinstein: Look, it doesn't matter if you're vaccinated or not. You could give ivermectin and you could visit your family member.
[02:12:33] Dr. Kory: You wouldn't fill these ICU's with these-- That's the thing. The data, especially from Mexico and preventing hospitalization, you're basically turning droves of people away from the hospital in ICU. It's huge.
[02:12:49] Dr. Weinstein: I do want to flag one thing. I don't think very far we can take it, but I do-- I've been watching COVID from the beginning and I've been noting what odd disease it is and how promiscuous it is in terms of creating symptoms, which is conspicuous evolutionary because in general, you would expect a pathogen to limit itself to infecting tissues that actually advanced its cause and to leave you.
It's not just one thing if it's malaria. Malaria wants you incapacitated so that mosquitoes can bite you, but a disease that is transmitted by people to other people doesn't want you incapacitated, it wants you mobile. The number of different tissues and the amount of damage that this thing does is a little bit incoherent, which could be the result of the fact that the behavior-
[02:13:41] Dr. Kory: Where it came from. [laughs]
[02:13:41] Dr. Weinstein: This is what I think is that the laboratory environment could well have generated a very unusual set of symptoms because the selection that goes on in these serial passage experiments is going to exert weird effects. You're selecting for things about the laboratory environment that aren't really about pathogenicity in the outside world. Anyway, not much to say about that, but yes, there is something weird about this disease, and that would be well explained by a laboratory.
[02:14:08] Dr. Kory: You brought something hugely important that I haven't talked about yet, but we talked about our protocols. Chronic prevention, post-exposure, early and late treatment. We actually are coming up with a new protocol, and this is fabulous, this is fascinating, but this protocol is actually not evidence-based in that we don't have trials to show. We know it works, but ivermectin is proven immensely helpful at long haul syndrome.
We have a protocol which Paul calls I Recover. We actually collaborated with a group of other clinicians and experts outside the FLCCC, kind of close kin, cousins, because we're all fighting the good fight, all good doctors. We did a very collaborative approach and we have a protocol now really centered on ivermectin and it's doing phenomenal. You have no idea the testimonials that we have gotten from patients suffering from disabling symptoms, literally can't go back to work because myriad syndromes. They take ivermectin and some of the testimonies are like within one day they felt better.
Now, a lot of times we have to continue that dosing for a long time and wean them off, sometimes we have to use steroids, but we are doing phenomenally against long-haul COVID. I think for your listeners, anyone suffering from long haul, come to our website, we're hoping it will be up within a week because we're just tweaking the diagrams and the dosing right now.
I also should mention that now, we're gaining increasing experience with post-vaccine syndromes that are really responding to ivermectin. One doctor, he's a retired physician who basically, his practice consists of friends and family, but he said during COVID that number of friends and family has gotten to-- he's almost fully working, but he's a phenomenally bright guy. He was telling me his experiences with ivermectin. He started telling me that some of his patients were coming to him with these terribly prolong inflammatory syndromes after the vaccine, like myalgias and pains and really felt terrible, headaches, fatigue, responded tremendously to ivermectin.
Now, a number of us in the FLCCC are also getting that experience. Although it's not evidence-based, there's no trials, but remember, ivermectin, one of the main mechanisms is it binds to the spike protein, and so what do the vaccines do? They make spike proteins and in some people the spike proteins make them sick and so it neutralizes the spike protein. Remember when I was talking like prevention is asking a little bit too much, what about if we asked for a drug that could work against long haul? That's not happening. [laughs]
[02:16:57] Dr. Weinstein: Then post-vaccine syndrome, no, that's-- You're getting greedy.
[02:17:05] Dr. Kory: I'm sorry. I'll stand out. I'm sorry. Just something got ahead of me. I agree.
[02:17:08] Dr. Weinstein: In fact, this is what I had on my paper to ask you about as our last question was, is there any hope here for these people? I've got to tell you, they write to me and I am saddened and sickened by their stories.
[02:17:28] Dr. Kory: Oh, my God. That's probably some of the most satisfying. One of the little nerdy things is in acute illnesses, you really do need a randomized control drug. So many acute illnesses are self-limited, they'll resolve. You'll never be able to tell if it's the medicine or not, but in a chronic illness, I maintain you really don't need a randomized control trial because if you look at some of these testimonials, the patients serve as their own control. If you have eight months of symptoms, Bret, and on a Monday I give you ivermectin and on Tuesday, you're feeling better, is it on that eighth month and seventh day of your illness, you suddenly decided to get better and that was the natural progression or was it the ivermectin?
[02:18:13] Dr. Weinstein: It could be true for a patient, but the point is it doesn't take very many instances. You're right. The person [crosstalk] longitudinal trial.
[02:18:20] Dr. Kory: If you did it to three patients who had months of symptoms and they told you that the very next day, all three, say they're better, you're done. That shows efficacy. I can give you a word document of all those testimonials that we've gotten on our website. We have multiple videos of people who we've interviewed who've told us their plight, their illnesses, and what happened after ivermectin. They're very compelling.
Those are the examples of when case histories are really compelling. You don't need a randomized control trial, someone who got better after four months of taking a pill.
[02:18:54] Dr. Weinstein: Well, you certainly don't need it. In the case of the pill in question, is itself safe?
[02:18:59] Dr. Kory: Exactly. You don't need the safety data. Yes.
[02:19:01] Dr. Weinstein: If you were sick with this thing and you've been sick and I would take one patient who had shown that effect that it would be worth a try and then if it doesn't work, it doesn't work. If it does work, then you know something and to the extent that if you've gotten multiple instances of this, it becomes a very powerful piece of evidence.
[02:19:20] Dr. Kory: One of the last-- I just want to make sure. Do we ever say our website so for people to go to?
[02:19:25] Dr. Weinstein: That's a really good idea. We will post some links to papers, some of the evidence that we have discussed. We will post a link to your website, but let's say it right now so people know what it is.
[02:19:38] Dr. Kory: Flccc.net, so Frank, Larry, ccc.net, so Front Line COVID-19 Critical Care Alliance. The reason I bring it up is because we've talked now for a while about what we've done and all we've been trying to do is develop effective treatment protocols and disseminate them, and we've gotten so much great feedback. Lots of intensivists from around the world have used our MATH+ protocol. Our I-MASK+ is now becoming-- many countries are using not the US. We're just getting a lot of success, and that's all we're trying to do. We're trying to help patients we took an oath to do the best we can, our patients using the best available evidence, and that's all we've done.
[02:20:22] Dr. Weinstein: All right. Well, this has been a spectacularly interesting conversation as I knew it would be. I am very hopeful that this message is unmistakable and that we will do the right thing from here. We will end the pandemic with the tools at our disposal of which ivermectin should be top of the list, and that then we can go about figuring out how we got into this mess, how we boxed it, and then what it was that actually brought us to our senses, and we can augment all of the things that worked.
[02:20:54] Dr. Kory: I would like what you just said. Thank you for helping us. I think this is such a hopeful development. If we can get this out and recognize, it's going to help so many people, so many people. The reckoning is going to be extremely ugly. When this history and this story is told accurately, it's going to be very unpleasant.
[02:21:18] Dr. Weinstein: Very, very unpleasant, but I also think that that means that we need to think about how we get to that reckoning, because the most important thing is this never happens again. When something does happen, we get on our game quickly, we do it well. We do not allow politics or financial concerns to interfere with our delivery of best medicine available and whatever that means, it means, but we need to get there because the amount of unnecessary suffering, harm, and loss that has already resulted from our myopia here is incalculable.
[02:21:58] Dr. Kory: I'm going to tell you one last thing, is that we're already thinking about that and working on ways in which we can prevent this from happening. I also want to mention that the FLCCC, where like the US group, there is an FLCCC in many, many countries around the world, and we're allied and communicating. There's the bird group in the UK. There's a group of doctors in Zimbabwe. There's another big collection in South Africa, in many countries and even in Europe. France has a group. Netherlands has a group that.
They're tiny, they're all getting suppressed. They're all getting drowned out, but a lot of us have thought-- we hope that with the credibility that I trust we'll gain if the reckoning occurs and it's accurate, that our credibility not only as our group, but in this constellation of groups around the world, we want to form like an independent--
When I say independent, no interest, no small dollar.
[02:22:58] Dr. Weinstein: One obligated to humanity.
[02:23:00] Dr. Kory: Exactly. You can't take anything more than $100 from anyone, something like that, and where we can really give independent opinions and we can look at repurpose drugs, the little guys that have no money behind them that we know have many different uses. We hope that that's one way in which we can avert this, but we need the credibility. People have to know that when the FLCCC says something, it should be listened to.
[02:23:25] Dr. Weinstein: Well, let me tell you something. There is a nasty pattern when we talk about no matter how cynical you are, you're still naïve. One of the nasty things that is evident if you look at other cases of whistleblowing and things like that, is that there is a terrible tendency not to vindicate those who were right. In other words, if you've been dismissed as a crank, then the narrative tends to want to hold you that way.
Now, there are narratives where this gets reversed, but in general, those who have fought you-
[02:24:00] Dr. Kory: You don't come out a winner.
[02:24:01] Dr. Weinstein: I think you're going to, in this case, because I think this case is so clear and your accomplishments outside of ivermectin are so good that you're unassailable and there are so many of you.
[02:24:16] Dr. Kory: We didn't just get lucky, right, Bret? The editor of the New England Journal of Medicine called me and then he said they got lucky.
[02:24:24] Dr. Weinstein: Well, you know what? I must tell you. In my career, I have had a lot of really silly things said to me about me and what I'm doing wrong and how dumb I am. I have this wall in which those little things live. Yes, you got lucky belongs on your wall.
[02:24:42] Dr. Kory: You've been called that before too.
[02:24:44] Dr. Weinstein: No, lucky has not-- My favorite of them is too clever by half. This is an insidious way to dismiss people, is too clever by half.
[02:24:56] Dr. Kory: Anyway. I appreciate it's been great to chat with you. I've really enjoyed talking with you. I think you have a great audience and followers. I think hopefully they're going to give this the credibility and give this the critical look and give more voices to the authorities that this needs to be listen to, this needs to be investigated and disseminated.
[02:25:18] Dr. Weinstein: I have no doubt that we did a lot of good today. I will say that you and your partners are true dark horses. The reason the podcast is named DarkHorse is that we need people like you to come out of nowhere and exceed our expectations, and I believe you have done that in spades.
[02:25:38] Dr. Kory: The DarkHorse COVID-19 Critical Care alliance. [laughs]
[02:25:41] Dr. Weinstein: Hell, yes. All right.
[02:25:42] Dr. Kory: I like it.
[02:25:43] Dr. Weinstein: Well, thanks so much, Dr. Pierre Kory. People can look you up on your website. They can find these protocols and if your doctor hasn't heard of this stuff, talk to them, point them to this podcast, give them a PDF. Anything that it takes for people to become aware that there is a tool that it does work, that the evidence is overwhelming, and that this pandemic could be brought to an end quickly. Let's do it folks. Thanks so much.
[02:26:12] Dr. Kory: Thank you. All right.
[02:26:15] Dr. Weinstein: Well, hold on.