My Replies to Some Contentious "Letters to the Editor" Attacking Ivermectin

A contact of mine just reminded me how much they enjoyed my replies to the angry “Letters to the Editor” sent in to the Jacksonville Daily Record after Matt Walsh published his opinion piece. So, I figured I would share them again just for fun.
 Dear Editor:
 Your article pushing Ivermictin as a “cure” or “preventive” or whatever for COVID was an abomination.
 There has been a large increase in calls to the Poison Control Line from people taking that compound. It is not approved and has not been shown to be effective against viruses, in particular against COVID-19 or its variants.
 You did a disservice to the community for writing that drivel, which will hurt more than help. Vaccines should be promoted as the only proven way to stop this pandemic.
 I hope that soon you will publish an article retracting your views on Ivermectin and set the record straight.
 EMERITUS PROFESSOR OF MICROBIOLOGY/IMMUNOLOGY
 Dr. Pierre Kory: The most easily quantifiable way to describe the indefensible lack of “approval” for ivermectin in COVID-19 is to note the actual amount of supportive  clinical trials evidence  in COVID-19, both randomized (31) and observational (32), including more than 26,000 patients with the near majority of all studies finding at least some important benefit with treatment.
 Then compare that evidence to the average amount of evidence relied upon to formulate the treatment guidelines of the Infectious Disease Society of America (IDSA):
 In a 2010  review  of 65 of its most recent guidelines, the IDSA found that 50% of guideline recommendations were made  without any  trials evidence in support and were termed “expert opinion only.”
 Another 31% of guideline recommendations were based solely on observational studies, while only 16% of all recommendations were based on at least one randomized controlled trial.
 In other words, the number of legitimate, clinical trials for ivermectin have been far superior to those for the IDSA’s treatment guidelines.
 Furthermore, ivermectin was approved for  the treatment of scabies  by the WHO based only on 10 randomized controlled trials, including 852 patients and despite the fact that the trials found ivermectin, although effective were actually inferior to the permethrin cream it was being tested against. It essentially won approval based largely on its low cost and ease of administration.
 I cannot recall the last pandemic of scabies that cratered health care systems and societies across the world. Yet, the WHO was able to arrive at such a bold recommendation without the pressure of a pandemic, given it was based on such a seemingly small evidence base.
 We also emphasize that the NIH Guidelines for COVID-19 have multiple strength levels of recommendation available to them, from weak/“consider” to making use near mandatory. The public should demand from the IDSA and NIH credible explanations for this monstrous anomaly of not arriving at even a weak recommendation for ivermectin, one of the safest, inexpensive and widely available medicines known to man.
 What you are witnessing is just the most absurd example of a decades-long war on re-purposed (a.k.a. “non-profitable”) medicines.
 Finally, no credible physician or journalist recommends that people self-prescribe with veterinary forms of ivermectin. Experts such as the Front Line COVID-19 Critical Care Alliance have been working tirelessly for months to persuade the public health agencies to provide more specific guidance to physicians on using ivermectin to treat patients with COVID-19.
 The increasing calls to poison control centers are a direct result of their failure to provide such guidance and education to U.S citizens.
 Editor:
 Which would you prefer to believe? Your unsubstantiated piece, or this science-based and logically argued piece refuting your claim:
 https://healthfeedback.org/claimreview/no-data-available-to-suggest-a-link-between-indias-reduction-of-covid-19-cases-and-the-use-of-ivermectin-jim-hoft-gateway-pundit/
 In any event, my point is that you are abusing your position by espousing a treatment protocol that is not fully supported by the scientific community.
 This can only serve to discourage your readers from doing what is proven to stop the COVID-19 virus, and that is GET THE VACCINE!
 Also, look at this from the Food & Drug Administration regarding your right-winged conspiracy theory “miracle drug” you were peddling in another one of your horrible opinion pieces:
 https://www.webmd.com/lung/news/20210823/stop-using-ivermectin-veterinary-drug-to-treat-covid-fda-urges
 Why don’t you keep these type of harmful BS stories to your Facebook and other social media cesspool groups instead of putting the local community at risk.
 You owe us a retraction piece and instead should be pushing the community to be vaccinated against COVID with the authorized drugs that are proven to work.
 We all know Florida and Manatee County are going through a health care crisis dealing with delta due to unvaccinated individuals. Do better for your community and promote facts or just stick to stories about the new restaurant or traffic light that needs installation.
 Please just stop spreading misinformation. Bottom line: Not enough evidence, so stop promoting these miracle drugs. You could get someone killed.
 What happened to high journalistic standards? At a minimum share the counter argument — FDA doesn’t recommend.
 BRADENTON
  Dr. Pierre Kory: Although epidemiologic associations between adoption of a medicine into state or national treatment guidelines and the subsequent rapid decline in case counts and deaths can never be used as definitive “proof” that a medicine is effective in treating the pandemic disease, such correlations can be viewed as a compelling adjunctive sources of evidentiary support. This is particularly so when the timing of adoption and the rapid decreases in cases and deaths is so reproducible from states, countries, or regions when widespread adoption can be accurately “timed.” Examples of these tight “temporal associations” can be identified from analyses of publicly available data paired with the timing of ivermectin adoption among numerous countries and states around the globe including  Peru ,  India ,  Argentina , and  Mexico  to name just a few. Further, although again not definitive, support can be found from what could be considered “natural experiments” which arose in India when  comparing case and death data from Indian states with widespread adoption  of ivermectin to those that prohibited use.
 Editor:
 A family member of mine had a serious case of scabies at a local nursing home in Jcksonville. The nursing home wanted to give her ivermectin. After reading the possible side effects and how those effects related to my family member’s health, I told them to not give her the medicine.
 Instead, they ignored my request. As a result of one single dose, my family member was admitted to a hospital and almost died.
 Ivermectin is not a cure for COVID. The advice of the majority of physicians with years of education and experience about Ivermectin needs to be heeded, not just a handful of doctors hand-picked to support your non-medical opinion.
 These types of COVID misinformation kill folks.
 I would like to see you take down this article before someone takes Ivermectin at your unprofessional advice, becomes severely ill and possibly dies.
 JACKSONVILLE
 Dr. Pierre Kory: In nursing homes and prisons throughout the world, during scabies outbreaks, ivermectin is distributed and administered to all residents, inmates and staff as a standard practice for controlling outbreaks. In fact, one of the first signals of efficacy of ivermectin in COVID-19 came out of a  group of nursing homes  in France, where one home had suffered a scabies outbreak such that all residents were treated with ivermectin. Administrators noticed that infections were halved (10.6% vs. 22.6%) and zero deaths occurred in that home compared to the 4.9% mortality rate amongst the surrounding nursing homes where residents had not been treated with ivermectin. Further, ivermectin is one of the safest medicines in history, having been mass distributed across continents to both young and old, healthy and unwell in the eradication of disfiguring parasitic diseases. The WHO has stated in their  guideline document  for scabies that the majority of side effects are “minor and transient.” Lastly, in the words of the world famous French toxicologist who just completed his  comprehensive review  on the safety of ivermectin, “severe adverse events are unequivocally and exceedingly rare”. Finally, in that same review, Dr. Descotes could not find one provable instance of a death caused by ivermectin, even considering the case reports of massive overdoses.

Summary: Matt Walsh, an "old-school journalist" is also the Publisher of the Jacksonville Daily Record. In August he wrote an opinion piece supporting ivermectin. Readers crushed him for it. I came in to help.


Will the Omicron Wave Carry Us Onto Endemic Beach By March?

Woke up last Sunday to a text forwarded to me by my wife. It was a series of notes taken by a good friend of hers which summarized the main points heard on a conference call with the International Head of Infectious Disease at Massachusetts General Hospital (i.e. “Haavaad”). This is what it looked like:

 I found it remarkable on a number of fronts given that this information;
 Comes out of the Top of the Ivory Tower of Ivory Towers (Harvard)

 Comes from the Director of International Infectious Disease

 Despite #1 and #2, the Director;
 Subtly questions the accuracy of publicly disseminated hospitalization data (a large number of us have long stopped placing high value on the disseminated aggregate U.S data as it is not only severely discordant with other countries’s data (U.K, Israel, S. Africa etc) but the underlying granular, “source” data is almost never supplied to the public. Plus, the U.S agencies history of data shenanigans in the pandemic is terrifying - i.e. remember when they made a rule to stop testing the vaccinated and to advise docs against checking antibodies on anyone prior to vaccinating them?

 Says that boosters will not be needed for Omicron . Wait, what? Scientific truth and logic is now coming out of a major academic institution in the U.S? No more of their long-standing, complicit (silent) support of an unending series of illogical policies around these novel vaccines? He openly says this while all the public health agencies and mass media continue to whip up fear of Omicron so as to try to increase vaccination rates? He even implicity brings up the reality that vaccines designed for older and fundamentally different variants have already shown either negligible or negative protection against Omicron. Whoa. He also didn’t bother (or forgot) to parrot the manipulative lie that vaccines are responsible for preventing hospitalization and death in Omicron? Who slipped this guy the Truth Serum?

 Offers a highly positive message in line with my growing and large network of COVID-expert colleagues in that the global data on Omicron strongly suggests it will infect such large swaths of society that things will get back to normal, based on the fact that natural immunity to (and displacement of) the more dangerous variants will result. And, we should be “getting to the other side” of the wave by March! Further:
 “Omicron approaching 100% of cases in Massachusetts” (this is the only statement I would need “real” data on as I am still seeing some amounts of Delta in my practice)

 “We’re all going to get it so contact tracing worthless.” (Umm, what contact tracing? Is that a thing in the U.S?)

 “No need to stay home unless in the extremes of age or chronic illness“ (what? No more huddling in our houses, trembling in fear? Woohoo!)

 “Very low risk of Omicron impacting the lungs.” YES!! (says the lung doctor)

 It so happens that right after I got the text I received a call from a friend, the investigative journalist Mary Beth Preiffer (she has expertly covered so many critical aspects of the pandemic including early treatments, ivermectin, vaccines, and the health agency corruptions). I shared with her the text given its relevance to an article she was writing about Omicron, and although I gave her my personal source of the text, she instead decided to go “straight to the source” to verify its contents, i.e. Dr. Edward Ryan and Mass General. Please read her substack below detailing their inevitable “walk back of” and “non-comment on” these statements. I guess the truth serum wore off. Bummer. It was a blast while it lasted, but it also means.. I CANNOT WAIT UNTIL MARCH!!!!
 RESCUE with Michael Capuzzo
 Mass General Expert Predicts: No Boosters. Normal Life. We Can Move on from Covid.

 This article is part of a publishing collaboration between Rescue and Trial Site News. The outstanding reporting by Mary Beth Pfeiffer will be simultaneously published in both outlets. Please subscribe to Rescue and Trial Site News for incisive pandemic reporting…
 Read more
 5 years ago · 61 likes · 9 comments · Mary Beth Pfeiffer

 Please folks, remember:
 World-wide Rally for Freedom Day, Sunday January 23 (note we are marching in solidarity with many other countries on that day)
 Join us for a March in Washington, DC to protest the numerous harmful infringements of societal and health freedoms that have been implemented in COVID, such as; forced COVID vaccinations of the naturally immune, forced COVID vaccinations of healthy children, and the interference with a physicians ability to care for their COVID patients.
 Gather at the Washington Monument by 11:30a.m. Then we will march to the Lincoln Memorial (1 mile) to listen to COVID thought leaders, experts, and activists as they give a series of short, powerful statements. I am one of them.. and I am pumped!
 United We Stand, in Peace We March.  Bring friends and jackets - and transistor radios in case you come late and/or can’t get close enough to the amplified areas of sound. Given the number of people estimated, cell phone service is unlikely to hold up, even for just radio.
 Go to https://defeatthemandatesdc.com/ for details
 Finally, I am honored to have been invited by Dr. Chris Martenson and Peak Prosperity to their Annual Seminar as part of a speaker panel including some powerhouse thought leaders. Don't miss it folks. Register using this link: http://peak22.events/kory

Summary: Although this article's headline may be one of the worst ever in COVID, it holds one of the most hopeful messages yet.


Saturday Night Fight.. At The Pharmacy

I am exhausted.. physically and emotionally and morally. Although I am not sure moral exhaustion is “a thing,” the daily witnessing of masses of physicians and pharmacists abandoning their core responsibility of placing the welfare of the patient as their primary consideration.. is beyond wearying. As my friend and COVID expert Dr. Hector Carvallo has long ago said, “it’s time for the lawyers.” It is becoming increasingly critical that the law profession aid the medical profession as it has long ago been led astray by captured federal pharmaceutical agencies. Note that I no longer call them “federal health agencies” as all their actions have been 100% consistent with what a pharmaceutical or vaccine manufacturer would want them to do. To prove that point, I simply ask that, when you read an announcement in corporate media that reports a new decision or action by the federal pharmaceutical agencies (FPA’s for short), simply ask yourself “is that what a pharmaceutical company would do?”
 Perfect example of this exercise was 2 days ago when it was announced that the “FPA” had authorized boosters for 12-17 year old’s against omicron (a generally mild cold in kids), using a vaccine designed for older, fundamentally different variants that have already spectacularly failed at giving protection against omicron given ever-increasing data of “negative efficacy” (i.e. vaccinated people are getting omicron more frequently than the unvaccinated). Yet the FPA “doubles down” with yet another “non-scientific policy” so that Pharma can increase the total market size of those eligible for a vaccine… and who cares if this decision ends up sending more kids to hospital than the disease ever would. Another brutal assault on public health. Another day in the United States of Pharma.
 In the United States of Pharma, individual docs and pharmacists have been led so far astray, forgivably or unforgivably, due to the relentless barrage of dis-information targeted at them by the FPA’s (further supported by relentless, daily propaganda appearing in both major media and medical journals). The resulting proportion of these two professions that have failed to display even a modicum of either critical thinking or moral conviction.. is terrifying. It is also causing lots of problems for patients and physicians (a colleague of mine now differentiates “doctors” from “physicians”, reserving the latter term for those who follow our guiding principles and ethics by always, always, putting the patient’s welfare as their primary goal above all else, even at personal sacrifice).
 What prompted me to write this substack was my most recent failure (and the resulting distress that led to crap sleep last night) over not being able to get a pharmacist to fill my orders in the hours prior to closing of pharmacies for an acutely ill COVID patient that had contacted me reporting high fevers, sore throat, and body aches. I immediately wanted to start him on a short course combination regimen of three, old, safe, cheap generic medications, all with large clinical trials evidence bases showing high efficacy against COVID (ivermectin, hydroxychloroquine, fluvoxamine). What is important to note is that, months ago I stopped trying to contact ANY pharmacy unless I KNEW they would fill my scripts for these off-patients medications because unless I knew a pharmacy was “safe”, I ran a high probability of entering an un-affordably time-wasting and ultimately losing argument with some smug, obstinate pharmacist. As a result, we early treatment docs have long since been forced to build lists of “safe haven” pharmacies where we know we can easily get access to these medicines for our patients.
 However, last night, I was inspired to make an attempt on a new, unknown pharmacy on behalf of my new patient as I had just read Steve Kirsch’s substack about my colleague and early COVID-treatment pioneer/expert Dr. Brian Tyson, in which was included the letter written by Dr. Brian Tyson’s attorney (also with the last name Tyson) that was used to “sway” a local pharmacy that had suddenly refused to fill.
 The letter is thorough , deeply well-argued, and informs the pharmacists that they are; 1) violating the civil rights of patients, 2) interfering with a physicians ability to practice medicine and 3) exhibiting behavior that constitutes the unlicensed and negligent practice of medicine. Now, I had argued all these points before in previous “conflicts” with pharmacists, but never all at the same time, and rarely threatening a lawsuit. Duly and newly emboldened.. I made the call.
 4:20 Pacific time (pharmacies close there at 6pm).
 Transcript (from memory):
 “Hi, I’d like to call in a prescription for a couple of patients.”
 “OK, what’s the first patients name and date of birth?”
 “Timothy Thomas (not his real name), born Nov. 6th, 1977.”
 (pause, clacking of keyboard)
 “OK, what does he need?”
 (Wait for it)
 “He needs ivermectin, 3 milligram tablets, I want him to take 15 each day as he is a big guy, and for 5 days with a refill. Then he needs, hydroxychloro…
 “Doctor, I am sorry but I cannot fill the ivermectin. The owner has said we are not to fill for COVID, there is no evidence it works.”
 “Listen, I don’t know who the owner is but you are the pharmacist on duty, and I am calling in a prescription to you, not the owner.”
 “I,I, I am sorry but I can’t..”
 I look at the letter, and then start spewing rapid fire arguments at him, “well unfortunately for you, my patient is an executive of a company and their lawyer is prepared to and will send a letter of intent to sue if it has not been filled because you are violating his civil rights, blocking my licensed ability to practice medicine and care for my sick patient, and you are clearly practicing medicine illegally and highly ignorantly. You should at least know what you are doing if you are going to do it without a license man"
 “But I am allowed to refuse doctor.”
 “That is what you think and what you have been told… But, I can promise you, that when you bring your arguments up in court as to why you refused, they will not hold up if any harm comes to my patient by your refusal. They will NOT HOLD UP, but you can try. The lawyer will serve the letter on Monday, I promise you, we are fed up out here and are fighting back, all of my fellow physicians being blocked by pharmacists are now using legal action (OK, so I overstated things a bit), I am sorry you are in the position you are in, but you have no rational or scientific evidence to support a refusal, but if you want to go to court to find out, we can make that happen for you”
 “I..I.. feel intimidated.”
 “Well, I am sorry for that, but you are hurting my patient and my ability to care for them. It is THEY who YOU are intimidating Sir. All you have to do is take my script, fill it, and we don’t have to go on like this. These medications are FDA approved, I am using them off-label based on a large body of evidence and experience in COVID, and off label prescribing is both legal and historically encouraged by the FDA. You are clearly practicing medicine and I promise that will be proven to you in a court of law. Please just fill it and you wont have to hear from me or my patient again.”
 (Pause, silence)
 “I cannot do it, I am not supposed to.”
 “OK then, I will also remind you that you are legally required to provide me your name and license number as we will be pursuing legal action against you.”
 “I am not giving you my name, I am not comfortable with that.”
 “OK, so you think I can’t find it out? Fine, I am also documenting this refusal. Again, I am not interested in a contentious argument, I am asking you simply to fill the prescriptions for two sick patients who need my help, and if you do, you won’t have to hear from me or the patient’s lawyer.”
 He whispers.. “OK, tell me the rest of the prescriptions.”
 I tell him the rest, then say, “my patient will be there by closing time, thank you and I apologize for my tone but I am just trying to do the best for my sick patients.”
 Victory? Yes! Haven’t won one of these in months.. the letter and it’s well articulated legal threats worked! Thanks Steve! Thanks Bryan (and your attorney)!
 I finish telling him the rest of the scripts for my patient and his wife (I also needed to call in medicines for her so she could have some on hand and also begin ivermectin as a prophylactic agent given it ensures an easier course even if she is already or eventually becomes infected).
 I then happily call the patient, tell him to get his wife to pick up the medicines along with the other over-the-counter compounds that have clinical trials supporting their use. And then I go to the couch to literally lay down (insane day of dozens of patient care requests, other zooms and phone calls, maybe 12+ hours on the phone).
 30 minutes later.. patients texts me.. my wife went there and the pharmacist wont fill.

 Now, despite the fact that I co-wrote a document with Executive Director Kelly Bumann of the FLCCC and Unity Project Founder Jeff Hanson, called “ Overcoming the Barriers to Access, ” which is a document full of sound, pragmatic tactics and dialogue examples offered to patients (and docs) in order to help them navigate such pharmacist obstructions, they typically will not work when it is an hour before closing on a weekend. So, here I am the next morning. Fortunately I was able to get 2 of the medicines filled through another pharmacy, with enough for his wife as she unsurprisingly fell ill overnight (omicron moves fast). Unfortunately, they will have to wait until tomorrow to get the 3rd medicine from a “friendly” or “underground" pharmacy (not really underground but you get the analogy).
 This is what it is like out here trying to fight for patients sick with COVID - widespread delays in care as blocking access to gneric or “repurposed” medicines by ignorant/arrogant pharmacists is ubiquitous. The majority of pharmacists (not all!) have simply stopped thinking critically or devoting effort to review the evidence base, instead simply believe what they are told by their Boards (a.k.a. their “Ministries of Truth”). As if the insane numbers of ill omicron patients to care for is not challenging enough.
 In the words of Louisiana Attorney General Jeff Landry, who went after his state’s Pharmacy Board when they tried to scare the states pharmacists away from prescribing ivermectin by sending them threatening letters, “it is shocking that pharmacists are suddenly developing a conscience after spending the last decade handing out opiates like they were M & M’s”. Well said and tragically absurd.
 This newfound conscience influencing such actions is likely further fueled by a sometime resident psychology of pharmacists who may feel “less than” a physician given their limited scope of patient care tasks. Emboldened by a seemingly legal opportunity to assert superiority and control over physicians, many find these irresistible. Consequently,they seem to be “getting off” from telling the “stupid” doctors that the Ministry of Truth has done the research for them and the Ministry has found, that in the name of science, doctors stop using “ineffective horse de-wormer” to treat COVID. Good times. Just another day in the life of an early COVID treatment expert.
 Let me end with the following disturbing data and observations. Take a look at this chart compiled by the FLCCC data analyst, Juan Chamie.

 From the above, it should be noted that prior to our FLCCC ivermectin paper being posted on a pre-print server (Nov 13, 2020) and prior to my testimony in the Senate hearings of Senator Ron Johnson noted above (Dec. 8, 2020), nursing home residents made up about 30% of all COVID deaths in the U.S. (also note that Senator Johnson’s efforts have made him one of the most (if not the most) impactful of the early treatment advocates for COVID in this country.. (and in history?).
 As you can see from above, suddenly, by mid-to-late December 2020, the proportion of dying U.S COVID patients that were residents in nursing homes started to plummet to now around 5-6% of all U.S COVID deaths.. and it has stayed stably low at this level ever since (notice how you never read any more newspaper reports of legions of people dying in nursing homes?). Hmmm. Was it the vaccines? Nope - nursing home resident vaccination rates were equal to or lower than the over 65 non-nursing home population, and the latter continued to make up a large proportion of COVID deaths in the U.S. So, why did nursing homes become such “safe havens” relative to the rest of society after December of 2020?
 I maintain there are two reasons; 1) nursing homes often have their own in-house pharmacy so do have to rely on negotiating with arrogant/ignorant retail pharmacists for access to medications like ivermectin, and 2) nursing home directors across the country learned that ivermectin is highly effective at preventing hospitalization and death , and thus they have widely used it across the U.S to treat COVID outbreaks in nursing homes ( here , here , here , and here ). Turns out, this practice makes for really good business since dead or hospitalized nursing home residents.. no longer generate income for the nursing home . Once again, all about the Benjamins. Shocker.

Summary: In the Omicron wildfire, with hundreds of thousands ill each day, U.S physicians and patients need their pharmacists support.. but most block access to generic medicines, fearfully and/or willfully.


The Global Disinformation Campaign Against Ivermectin in COVID-19 (Part I)

Ivermectin, a decades-old, off-patent drug costing pennies to make, with an unparalleled safety profile and numerous manufacturers across the world, actually sits atop one of the largest and strongest clinical trials evidence base in history. The existing, massive amount of clinical trials data shows immense efficacy against COVID-19 in all its phases; prevention, early and late treatment, and long-haul syndrome (no actual trials in long-haul but rather extensive positive clinical experiences). Despite this inarguable (yes, inarguable) supportive evidence, no major Western or international health agency has recommended its use in COVID-19. Conversely, ivermectin has been officially adopted for early treatment in all or part of 23 “less developed” countries (39 if you include non-government medical organizations), and which include about 25% of the world’s population.
 Now, before we delve deeper into the workings of the most heinous disinformation campaign ever waged by the pharmaceutical industry in history (and also it’s most successful so far as 75% of the earth’s inhabitants still have not been recommended to use it to treat COVID), I will ask you not to just “take my word for it" but instead take you on a brief, guided tour of the insanely positive evidence base supporting the use of ivermectin in COVID-19.
 Let’s go. First, the below “Forest Plot” was compiled by the anonymous expert research group at c19early.com (not enough can be said of the impact their meticulous work has had on COVID clinicians and scientists across the globe). Please visit their site , it is mind-blowingly impressive. The compounds listed in the rows represent the medicines with the most clinical trials evidence as of today, either by size or by number and are listed in order of potency against COVID.

 Here is how to read and understand a Forest Plot: there is a thin grey line in the center, on either side of which are plotted squares which represent an estimate of the true size of the “treatment effect,” derived from an average of the treatment effects measured from all the trials performed of that medicine. If the box is squarely on the vertical line it means it is a treatment whose benefits have been found equal to its harms. In the above list, (with the exception of one) medicines with “positive” treatment effects are listed, meaning the benefits of treatment with these agents outweigh any potential or actual harms. No medicine on the list above, besides convalescent plasma (CP), indicates it is inferior to placebo (note that CP was the initial favored therapy of every single academic medical center in the U.S despite the fact CP has only ever been shown to be effective in hematogenous infections). In cases, such as with CP, due to the fact it’s harms outweigh it’s benefits, the box is plotted on the right side of the line and shaded in red. Conversely, the farther to the left of the vertical line that a box is plotted, the larger the measured impact on the clinical outcome tested. Green boxes indicate the effect estimate is based on at least 4 trials. Grey boxes and greyed out medicine names mean the estimate for that medicine is based on fewer than 4 trials. The thin horizontal line through each little box indicates the degree of precision, i.e. how confident we can be in the estimate of the treatment effect - narrow horizontal lines through the boxes mean the data in support is large and consistently positive and is “statistically significant” in favor of the medicine. The wider the line, the less consistent, or less amount of data can be relied upon to make the estimate. When the horizontal line through a box extends across the vertical gray line, this indicates that it is statistically possible that the true estimate may actually be in favor of placebo!
 With ivermectin, what sets it apart from all the other compounds tested, is the sheer number of randomized and observational controlled trials that have been performed to date. It is #1 among the “green box” compounds given it has been tested in 73 controlled trials which include an unheard-of 56,804 patients. Why unheard of? Because never in history has a medicine been so thoroughly tested, with such consistent positive results, yet led to a situation where governmental agencies in highly developed countries call for even more placebo-controlled trials to be done.. and then slow walk to doing them. The ethics of giving a covid patient a placebo given this amount of supportive data are too miserable to contemplate this early in the article (fun fact - I was personally asked to try to help recruit patients for the ongoing University of Minnesota placebo controlled RCT. I got off the phone as fast as I could). Another not-so-fun fact: penicillin was mass deployed to great effect to all our troops for their battlefield injuries in World War II.. based on a case series of 157 patients where their bacterial infections overtly resolved without signs of toxicity during treatment. Not one RCT was done before this decision was made by military and medical leaders.
 The only other medicine with a larger supportive evidence base is hydroxychloroquine (HCQ), especially when only the early treatment trials of HCQ are considered as that collection of trials results in an equally impressive position on the Forest plot (not shown). A tired topic I will explore later is the much parroted (and highly favored by Pharma) notion that “retrospective, observational controlled trials (OCT)” cannot be trusted as they are inferior to “proper, large, double-blind, randomized, placebo controlled trials (RCT).” This notion is not evidence based. Even the captured (I know, sorry) Cochrane Library knows this. They themselves have shown that, on average, over thousands of clinical trials, over decades of research, OCT’s and RCT’s reach the same conclusions. So stop with the false dichotomy. Pharma wants you to only trust in “large RCT’s”.. because they are the only ones with the cash to do them. That way, they can control the only medicines that get “proven” and thus adopted into guidelines.
 Two absurdities (crimes) must be highlighted in the above diagram – one is the sheer number of medicines with demonstrated efficacy, most costing under $5 a dose (and almost all with unparalleled safety profiles and/or “over the counter” status) that are still not recommended by any U.S or “western” health agency (with the exception of the state of Florida since the hire of Surgeon General Dr. Joseph Ladapo who has put together a terrific public health campaign supporting the use of a combination early treatment protocol which includes another FLCCC adopted drug, fluvoxamine).
 Meanwhile our federal governmental health agencies, which I have argued repeatedly (and will for years until it stops) are so completely captured by the pharmaceutical industry that they have not advocated for any one of these “repurposed” compounds, even as a “precautionary principle” (meaning that even if the purported benefits may not be realized to the extent estimated, the risks are so small it is more likely best for all we employ them now in early treatment given the world is cratering). Their most unforgivable and absurd inaction is the deliberate ignoring of the critical role of Vitamin D in protecting against the worst outcomes of COVID, despite knowing full well significant portions of the U.S population is Vitamin D deficient. Even Anthony Fauci recommends to himself that he take Vitamin D… regularly. The data below was given to me by a Dr. Henele and is from work he published in 2016. Note the percent of the U.S population that is critically deficient in Vitamin D.

 The second absurdity is found when looking at the plot with only the medicines recommended in the NIH’s COVID protocol circled . Note that the NIH protocol is adhered to by almost the entirety of the country’s hospitals (largely due to large add-on bonuses paid to hospitals when the protocol elements are used - I am not making this up). A “theme” should begin to emerge as you look at the circled, “recommended” medicines vs the non-circled, “non-recommended” medicines - every single one is massively expensive. Every single one. Note not one inexpensive drug is circled. How much more evidence do you need to prove that our agencies have been completely captured by the pharmaceutical industry?

 Fun fact now that you are en expert in reading Forest Plot’s: Merck’s mutagenic new drug molnupiravir, after the highly positive results from their study’s “interim analysis,” published in a press release , instead found that, in the 2nd half of its one study, the data favored… placebo. Thus if the 2nd half was a stand-alone study (which it arguably could have been) it’s box would be firmly on the right side of the line. FDA still approved… while feigning concern. Unsurprising really.
 Now, beyond the above 73 controlled trials supporting ivermectin, there are, in addition, numerous health ministries from around the world that deployed ivermectin in either the prevention or early treatment of COVID, among often very large populations. Each program’s report found that ivermectin use led to massive reductions in the need for hospitalization and/or death ( Mexico City , Uttar Pradesh , Brazil , Misiones , La Pampa s, Peru , Phillipines , and Japan - I will do a deeper dive on these in a later post). The program in the city of Itajai, Brazil is both the largest study of ivermectin in the world (data from nearly 200,000 patients was carefully collected over a 6 month period) and most impressive. They found that, despite the fact that the 120,000 patients who agreed to take ivermectin every 15 days were older, fatter, and sicker than the approximately 37,000 that did not...they went to hospital 67% less frequently, and died 70% less frequently.. from all causes, not just COVID. The issue with ivermectin as a therapeutic in COVID.. has NOTHING to do with the science.
 The issue with ivermectin is simply it’s price - it costs less than a $1 and represents the biggest threat to the immense and future profits of the pharmaceutical industry’s novel oral anti-viral drugs… as well as their vaccines .
 The previous title holder of the largest threat to Pharma profits in COVID was the highly effective (and also anti-viral) drug hydroxychloroquine (HCQ). However, it lost that title after the 2020 war on HCQ was essentially won by Pharma (for now?), using tactics so sinister as to be unimaginable, and which I will not review here as that macabre war has already been expertly reviewed in incredible and highly referenced detail in the book “ The Real Anthony Fauci ” by Robert F. Kennedy Jr. His book, in my opinion, is a must read for all the globe’s citizens, as without it, no coherent understanding of the innumerable non-scientific actions and policies across the entirety of the developed (and majority of the undeveloped) world can be gained.
 I must emphasize that ivermectin is just the latest drug under attack during Pharma’s long-standing (and highly successful) war on off-patent, “no-longer-obscenely-profitable” medicines. Books have been written about the numerous, and often criminal actions that Big Pharma has employed to replace older off-patent medicines with newer, highly profitable, and often poorly tested drugs with either prospectively known dangers or quickly discovered dangers which they then criminally suppress or distort to preserve profits. When science supporting older, off-patent, often “repurposed” medicines (particularly in the lucrative environment of a global pandemic) becomes “inconvenient” to the financial promise of newer agents, the industry employs what are called “Disinformation” tactics, first invented and perfected by the Tobacco Industry, and now used to great effect by the Pharmaceutical (and many other) industries. These tactics are brilliantly and succinctly summarized in an article called The Disinformation Playbook written by The Union for Concerned Scientists . I encourage all to read. The 5 main “plays” from the playbook are listed below. If you are at all versed in the ivermectin in COVID saga (many FLCCC followers are), it should be easy to quickly come up with numerous examples of each nefarious tactic. I give some hints below..
 1) The “Fake”: Conduct counterfeit science and try to pass it off as legitimate research (Dr. Andrew Hill)
 2) The “Blitz”: Harass scientists who speak out with results or views inconvenient for industry (attacks on FLCCC founders)
 3) The “Diversion”: Manufacture uncertainty about science where little or none exists (Dr. Andrew Hill/captured high-impact journals)
 4) The “Screen”: Buy credibility through alliances with academia or professional societies (i.e. high impact medical journal influences)
 5) The “Fix”: Manipulate government officials or processes to inappropriately influence policy (i.e. capture the health agencies by creating “revolving doors” between Pharma and government to ensure total synchrony in objectives amongst their leaders)
 Given the Disinformation Playbook was last updated in 2018, it does not include newer, more nefarious tactics that industries have been able to deploy since the historic consolidation of financial power by just 3 multi-trillion dollar investment funds (Black Rock, State Street, and Vanguard). These three corporations have now acquired influential or outright controlling investment stakes in nearly every major corporation in nearly every industry. These investment managers power, particularly the power held synchronously over media companies, social media companies, and the near entirety of the pharmaceutical industry, has allowed even more fearsome tactics to be used in the near-global suppression of the efficacy of ivermectin (and HCQ) as they now:
 1) CENSOR any mentions of supportive evidence in corporate, (a.k.a. “legacy”) media. Note that, besides the influence of these investment manager overlords, the global censoring ability of media was greatly helped by the “Trusted News Initiative (TNI),” an obscene (and either naively misguided or completely corrupt) effort by the most powerful journalism organizations in the world to band together to try to control the spread of “mis-information”. Yes, professional journalists decided they needed to control information in a pandemic. I am not making this up. Would an appropriate analogy be that a bunch of physician leaders decided t hey needed to spread disease in a pandemic?
 2) CENSOR any mentions or discussions of efficacy on almost all social media - see explicit youtube “community” policy below as the most unsubtle example:
 YOUTUBE COMMUNITY GUIDELINES

 3) RETRACT positive papers from impactful medical journals (3 fully peer-reviewed and highly supportive scientific reviews of ivermectin have been retracted, either immediately prior to or post-publication (I was the lead author on the first one with my FLCCC colleagues)
 4) BLOCK review and publication of positive trials of ivermectin in major medical journals (in my now global network of ivermectin-expert and/or ivermectin study investigator colleagues, all lament how their positive clinical trials or papers were rejected for review from all the high-impact (captured) journals, with Dr. Eli Schwartz’s highly sophisticated, expertly conducted, and immensely positive study from Israel being one of the most illustrative examples
 5)PUBLISH numerous “hit pieces” within high profile print media outlets discrediting the science and/or the scientists who support the medicine. This is actually an example of the already described “Blitz” tactic, but in 2021, during COVID, using total media control, it was deployed by a division of Howitzers. A more recent and relatable example of “the Diversion” tactic was when the NFL used media hit pieces to go after the scientists (and their inconvenient science) after they began publishing and disseminating data about the high rates and disastrous impacts of chronic traumatic encephalopathy in retired NFL players.
 What I have found fascinating, is that for every planted hit piece article discrediting the mountain of evidence supporting ivermectin as a therapeutic, the FLCCC is actually rarely mentioned. But why? I think it is because the FLCCC is a sizeable group of highly published physicians and researchers (Professor Paul Marik is actually the most published practicing ICU physician in the history of the specialty). Thus, it’s hard (but not impossible) to call us “fringe.” The last thing they want to do is call attention to our high degree of credibility. Instead they seem to be trying to destroy it using separate hit pieces (among other tactics) which has led to the recent loss of employment for three founding FLCCC members (Drs. Marik, Meduri, and yours truly have been forced to leave jobs or had their exemplary clinical and research careers ended (Drs. Marik and Meduri). An article on ivermectin that does not mention our organization does so purposefully so as not to give attention to credible support for its use given we are considered the foremost clinical experts on the clinical use of ivermectin in COVID in the world.
 6) employ a coordinated media-government agency PROPAGANDA campaign;
 August 26th, 2021: Pharma used their CDC to send out a “health advisory” to all 50 state Departments of Health, which they then sent to all the physicians licensed in their respective states (a terrifying example of the immense destructive power of a federal agency captured by pharmaceutical industry interests). The bulletin both;
 1) depicted ivermectin as a dangerous drug by deliberately exaggerating reports of calls to poison control centers
 2) cited the meaningless fact that it “is not FDA approved for COVID” as a reason it should not be used, hoping doctors may not realize that “off-label” prescribing is both legal and encouraged.. by the FDA.
 Next, a quickly debunked (not quickly enough) planted media article in Rolling Stone appeared with an impressively click-bait-able headline describing emergency rooms so overflowing with ivermectin overdoses that our nation’s gunshot victims couldn’t get (obviously) needed care (even I clicked on it). The article then went viral across the world (thousands of media mentions) before the hospital could put out a statement saying it was 100% false. Gee, do you think Pharma hired a professional PR firm to pull that one off or did they just benefit from a serendipitous and lamentably lazy journalist’s error?

 Then, in another terrifying example of the control of major corporate media.. for week after week every news broadcaster, pundit, and late-night talk show host prefaced the word ivermectin with the descriptor “horse de-wormer.” Over and over and over again (totally pissing off Joe Rogan who recovered from COVID with ivermectin as part of his combination protocol- hah!)
 Then finally, in a coup de grace, in comes Pharma’s FDA proudly using twitter to associate ivermectin with, you guessed it, horses. Janet Woodcock, the acting Commissioner of the FDA, even sent out a congratulatory email to her team about the success of the tweet.
 Was this a coordinated attack led by an expert team of brazen PR professionals who have a fondness for horses… or did it arise organically via a series of disconnected events?
 If you are still not convinced of the former, I need to point out that this “series of disconnected events” had an uncanny sense of when to “roll-out.” The CDC’s Health Advisory was issued on August 26th. Look at the below chart and see if you can find any reason why it would start then? Recall that the advisory was ostensibly in reaction to false “reports of calls to poison control centers”. The below chart shows instead what was really going on at the time - hundreds, if not thousands of licensed medical professionals across the country were prescribing ivermectin like mad during the terrible, and deadly summer surge of the Delta variant. Was someone getting nervous that a “dirty little secret” was being rapidly discovered by American citizens and physicians? The answer is a definitive yes - thus triggering Pharma to nefariously try to “stuff the genie back in the bottle” by unleashing their terrifying disinformation propaganda campaign.
 NUMBER OF IVERMECTIN PRESCRIPTIONS DISPENSED IN THE U.S OVER TIME

 But check this out.. the good ole’ FLCCC, my little band of brothers and sisters, is somehow making a opening in the wall of information suppression and distortion as shown in the chart below (compiled by our data analyst and ivermectin expert, Juan Chamie). I say this makes us “the Bad News Bears” in the repurposed drug war.

 I am going to stop here.. and call it PART I. There is way way more to this story. so stay tuned.
 P.S I just want to say how much I appreciate all the subscribers to my substack, and especially the paid ones! Your support is so greatly appreciated. Thanks my friends.
 Subscribe now

Summary: The tactics deployed by the pharmaceutical industry in their decades-long war on generic drugs reached a zenith during COVID-19... and have resulted in true crimes against humanity.


A Journey Through Omicron… Riding The Ivermectin Train

Photo #1 - 10 a.m December 30th. My patient takes a selfie to send to husband to tell him how sick she is feeling

 Photo #2 - Positive Home Covid Test confirms diagnosis

 Photo #3 - 1 p.m Temperature Check: 104.5!!

 Not Pictured - 2p.m. - Patient takes first dose of ivermectin - 0.4 mg/kg, 50mg zinc, 4,000 IU Vitamin D3 (not pictured)

 Photo #4 - 5 p.m. - The Depths of Omicron - taken by friend she is on vacation with

 Photo #5 - Next morning, Dec 31, 10 a.m heading back to Florida in car with kids, taken to show her doctor she appreciates the care (awww)

 I know, I know, this is just “anecdotal”, “coincidental”, “she would have gotten better anyway”, “its just Omicron” etc. Thats where I call BS - Omicron is a lot of things, it might only rarely cause death, might not need hospital for most, but it is kicking the crap out of the MANY dozens of patients I have treated this week.
 Still, we should get that 35th randomized controlled trial of ivermectin up and running STAT.
 A Happy New Year to my dear patient.. and a Happy New Year to ALL!
 P.S. A good new years resolution is to stop listening to these captured agencies, make sure you have ivermectin in the cupboard for any family member who hasn’t gotten COVID yet (and even those that have). Forget molnupiravir, forget paxlovid - they are barely tested, mutagenic, failed, or dangerous drugs with narrow windows of efficacy.

Summary: A grateful patient shares a photographic record of her lightning fast recovery from the depths of her omicron hell.


In 2021, my life was transformed in ways I never thought possible, the least of which was having to leave an ICU job for the third time in the pandemic, effectively ending my career as a practicing ICU specialist and teacher (hopefully just for the time being). Despite all that I lost, what I gained in wisdom and purpose (and friendships) will serve me for the rest of my life. Below is the letter I wrote for the FLCCC substack. Enjoy.
 The FLCCC Alliance Community
 Four things I learned treating patients and fighting for medical freedom in 2021

 After a year like the one we’ve just had, it’s important to take a moment to reflect and distill lessons that may help us change course towards a happier destiny …
 Read more
 5 years ago · 33 likes · 11 comments · Pierre Kory

Summary: I distill the lessons that could lead society and health care to a better place next year.


"Effective immediately, patients will no longer be allowed to be on ivermectin, even if it is their home medication. Happy Holidays!"

Check out this beauty of a holiday memo to hospital staff. This hospital’s PNT (Pharmacy and Therapeutics) Committee, in their infinite and unquestionable wisdom, came to the communal decision that, even though an admitted patient had already been started on a prescription for ivermectin in the treatment of COVID-19 by their personal physician, it was imperative they immediately terminate the use of non-overlord agency approved medicines.

 Hey America, you guys had enough yet? Now you know why we are marching on January 23rd? If you stay home, that makes you complicit. LET’S MARCH. Otherwise it is only gonna get worse. See you in DC.
 JANUARY 23rd March on Washington. An American Homecoming https://defeatthemandatesdc.com/

Summary: Good ole’ American Heath care in the COVID-19 Pandemic. What. A. Farce.


Hospitalized COVID-19 Patients are Systematically Dying from Under-Treatment with Corticosteroids - PART 2

In Part I, I began assembling the building blocks to support my argument that hospitalized COVID patients around the world, nearly all of whom have entered the “pulmonary phase” of the disease, are dying due to being systematically underdosed with corticosteroids in what is a profoundly corticosteroid responsive disease . How this continues to happen almost 2 years into the pandemic is, like many many other pandemic realities, simply unforgivable. Let’s review where we left off:
 This paper by founding FLCCC member Dr. Umberto Meduri, a world expert on the use of corticosteroids in critical illness and acute respiratory distress syndrome (ARDS), found that in the best ICU studies of prior viral pandemics, corticosteroids decreased mortality by 50%.
 Note that in one of the main studies he referenced, they compared different doses of corticosteroids used in viral ARDS and found that 80mg of methylprednisone daily led to the largest improvements in survival, a dose far higher than the 6mg of dexamethasone the world uses now (that dose is approximately equivalent to 32mg of methylprednisone)

 This paper by founding FLCCC member me, which compiled all the evidence that COVID pneumonia is actually a rare-ish diseae called “organizing pneumonia,” (OP) and the gold standard treatment of OP is corticosteroids , and in “fulminant” cases of OP, high, “pulse doses” (i.e. sometimes equaling 1,000mg daily of methylprednisone for 3 days) are recommended.

 Note that these two papers were published or being reviewed by journals in the Spring of 2020, a period marked by a widespread prohibition against their use while inexplicably high mortality rates, with frequent prolonged durations of mechanical ventilation (MV) were being reported among multiple early studies of COVID-19-associated acute respiratory failure. These reports were emanating from centers expert in such supportive care strategies. Yet, many of these same centers were literally running out of ventilators and governmental agencies started scrambling and competing to purchase huge lots of them.
 In critical care medicine, I am what is known as a “vent geek,” having long ago developed an obsession with setting pressures and flows, initiating weaning , and interpreting waveforms. Further, given I was the Medical Director of the Trauma and Life Support Center at the University of Wisconsin at the time, the State Health Department had me on daily calls helping them evaluate the strengths and weaknesses of the various, often older or more basic ventilators being offered to them by vendors in large numbers.
 To get a sense of how bad critical care docs were failing at keeping people off ventilators or successfully liberating them once on, one major heath system in Manhattan went from having 95 ICU beds across their 6 hospitals to 345 ICU beds in the span of two weeks (personal communication with system critical care leadership). This was all occurring in the setting of a widespread “supportive care only” strategy; meaning simple Tylenol, hydration, nutrition, and oxygen. No specific therapies were tried.. which led one major center in the New York City area to publish an 88% mortality for those on ventilators (umm.. 30% ICU mortality is considered very high). But more and more evidence supporting corticosteroids was accumulating..while critical care systems were cratering;
 This remarkable study matched the inflammatory gene expression patterns induced by SARS-CoV2 in human lung tissue tissue against a database of the expression of gene suppression changes triggered by over 5,000 FDA-approved drugs.. and found methylprednisolone to be the drug with the greatest potential to revert the changes induced by COVID-19, while other closely related corticosteroids, such as dexamethasone or prednisone, were not. Methylprednisone was #1 out of over 5,000 medications. Also note this type of search for and analysis of existing therapeutics mechanisms of action allows for the rapid identification of optimal therapeutics - a powerhouse approach in a pandemic situation (and avoids the years of delay and billions of dollar needed to develop novel, high-cost, patentable drugs such as the mutagenic molnupiravir that the system is trying to shove down our throats. Just sayin’.

 Observational studies reporting large impacts of corticosteroids from Detroit and Italy started to appear on pre-print servers.. and were promptly ignored beause they were not gold-standard randomized controlled trials (fun fact: on average, randomized and observation controlled trials throughout the history of modern evidence based medicine..reach the same conclusions. A known fact proven over decades, yet suppressed and fought against by Pharma who instead prefer Science to rely solely on big Pharma conducted RCT’s to “prove” something works or doesn’t.

 Physicians on social media.. started to make noise. Hospitalists and intensivists started posting, largely anonymously, compelling observations and experiences, essentially crying out for doctors to start using corticosteroids at the first sign of low oxygen in COVID patients. Some memorable posts read as follows:
 “We floundered for two weeks. Lots of codes, intubations and death. Maybe 15 discharges. We started steroids and discharged 250 patients. Less intubations, less codes. And the ones that ended up on vent, not as serious. CXR/CT Changes = steroids. Hypoxia on admission = steroids. Ambulatory hypoxia = steroids. Completely changed our trajectory Steroids are a game changer.” Hospitalist, SE Michigan - our group is taking care of 700 plus COVID+ patients

 “I'm here in New Orleans, since we started using steroids, we were able to free ventilators and get elderly patients out of the hospital without needing a ventilator. Patients that were obviously crashing quickly, who we had to have end of life talk with were able to walk out of the hospital. At no point did any of our patient’s worsen because of steroids. These patients shed viruses 4 weeks later, with or without steroids. The virus doesn't kill anybody, it’s the inflammation that does. Let the virus replicate however slow down the inflammation”

 Since this info emanated from social media and was not approved by the agencies or the journals, it pretty much met the definition of what would later be attacked as.. medical misinformation . Or were they instead valuable “reports from the front lines?” Yet the authorities continued on with their damn “supportive care only” approaches. ICU bed numbers continued to swell.. and people died. A lot. Often after weeks of being in hospital or ICU, lonely, not able to see family. Unforgettable.
 I/we in the FLCCC got lucky when I was invited to testify in the U.S Senate by the Senator from Wisconsin, Ron Johnson, who chaired the Senate Committee on Homeland Security & Governmental Affairs. He decided to hold hearings as to why, in my words (and likely his too) “the doctors were not doctoring” and U.S citizens were effectively being denied treatments or attempts at treatment. Spot on really. I got the invitation because he had found the FLCCC website and protocols and noticed that one of the founders was from Wisconsin so I immediately received a phone call and invitation. Watching it again, a year and half later, I was struck about how much we knew back then about how to treat the disease and how strongly we made the argument for corticosteroids. Months before all the randomized trials (RCT). Furhter, I must point out that I every element of our protocols was incorporated many months before later having been proven in an RCT. With corticosteroids, it was not until late June 2020, when a press release announced from across the pond, that Oxford University’s RECOVERY trial, testing 6mg of dexamethasone daily, had found a small, but statistically significant reduction in mortality when used in patients on oxygen and an even larger one in patients on mechanical ventilation.
 The only question that remains is.. what else have we learned about corticosteroid type, dose, or duration since the Oxford study in June of 2020? Turns out.. a lot. Check out this table I made below, and look at the column “number needed to treat (NNT)" to save a life.” The NNT is one of the most valuable measures in medicine as it indicates the potency or impact of a medicine on a certain outcome. Note that the lower the number, the higher the impact. And you can see, that higher doses, especially of methylprednisone (shocker) are FAR superior than using 6mg of dexamethasone. Over and over, by comparing studies side by side, or head to head (bottom rows), methylprednisone, at higher doses, consistently leads to many more lives saved. Especially when started early in the hospital.

 The trial from Iran by Edalitifard (first row) is by far the most impressive. They gave 250mg of methylprednisone for three days to patients in the “early pulmonary phase,” before they required intubation and mechanical ventilation. They reported a massive mortality benefit with an NNT of 2.7. Meaning that for every three patients you treated with that dose and drug, one life would be saved compared to if you had not done so. This is a massive effect in medicine. Of note, when you perform electrical defibrillation of a patient dying from a malignant arrhythmia like ventricular fibrillation, that has an NNT to save a life of… 2.5. So, giving a COVID patient early “pulses” of 250 mg of methylprednisone is akin to defibrillating someone out of a life-threatening ventricular arrhythmia? Wow. Yet the world continues giving 6mg of dexamethasone daily.. which has an NNT somewhere between 8-29.
 As an intensivist who has known this data for over a year, has worked in ICU’s in 5 different hospitals around the country, has repeatedly begged my hospitalist colleagues (the docs caring for the patients before they crash into ICU’s) to be more aggressive with corticosteroids so as to avoid deterioration and needless death, I have rarely succeeded in getting my colleagues to change their corticosteroid dosing practices (they are seemingly all waiting for this recommendation to be incorporated into a guideline handed down from the “gods of science and knowledge” in Washington). Unreal..except it’s not. I have been watching needless death all around for so long… I am almost used to it. Almost.
 You want to know what is even worse about all this insanity? It’s that I truly believe the hand of Pharma influenced the design of Oxford’s RECOVERY trial. I am now convinced they purposely used a low dose of corticosteroid, knowing that the massive efficacy of higher doses would obviate the need for more expensive, on-patent anti-inflammatory therapeutics, i.e the “ibs and abs” that they pair the anemic dose of dexamethasone with (i.e. tocilizumab, baricitinib, and sarilumab). Too cynical? Me? Never. Like Bret Weinstein said to me a while back, “every time I think I am being too cynical, it invariably turns out I am being naive.” The United States National Institutes of Health COVID-19 treatment guidelines are below. Read ‘em and weep. But like, really weep. Weep like all the American families have over their lost loved ones, all fucking 800,000 of ‘em.

Summary: US hospitals and their doctors almost never deviate far from the standard, anemic NIH recommended dose of 6mg of dexamethasone daily. Numerous studies support far higher doses far earlier in disease.


Hospitalized COVID-19 Patients are Systematically Dying from Under-Treatment with Corticosteroids - PART I

As a now renowned (infamous?) U.S pulmonary & critical care specialist with numerous co-authored publications and extensive experience treating COVID-19 in all it’s phases, almost every day of this pandemic, and sometimes multiple times a day, I am contacted by someone in my ever-widening circle of friends, family, or colleagues asking me to help a loved one who is deteriorating from COVID in the hospital. The case is invariably one of an often older (but not always) patient mired on a hospital ward or in an ICU, whose illness has progressed to the point where they require near maximal or maximal oxygen/ventilator settings and the patients and family members begin to question whether “enough is being done” or “is there more the doctors should be doing?” So they reach out.. desperate for help.
 The therapeutic regimen that their loved one is on is nearly identical in almost all cases, especially on the hospital wards where a generally anemic dose of a corticosteroid called dexamethasone (standard of care worldwide for COVID patients in the pulmonary phase of disease), along with remdesivir (“run death is near” as some nurses have called this drug), and occasionally a medicine ending in “ib or ab” (classes of expensive medicines that block a specific inflammatory mediator called a cytokine, such as tocilizumab, sarilumab, or baricitinib) and some form or dose of a blood thinner. If lucky, some may get high-risk, costly interventions such as Vitamin D or zinc or melatonin (sarcasm noted yes?), and patients are generally on or have completed some almost certainly unnecessary antibacterial agent “just to be sure.”
 In later posts I might explore some of the above raised issues more deeply, like the corrupt dangers and inefficacy of remdesivir, the costly and needless “ibs and abs”, antibiotic over-use etc. but today, I want to focus on the singular and most important treatment deficit (too low a dose of corticosteroid), which, if systematically corrected, likely presents the greatest opportunity to improve the survival chances of COVID-19 patients after entering the hospital by keeping them out of ICU’s and off ventilators (and reducing the accumulating PTSD I acquire from these daily calls for help). Please note that in almost every single instance that I am asked to help, I can offer zero help because less than 1% of physicians either feel they need outside help or desire to have a clinical discussion with a supposed “expert” (the near majority of docs are convinced they know COVID as much or more than anyone else).
 So, I thought it might be interesting to run through the “history” of my own and the Front-Line COVID-19 Critical Care Alliance’s (FLCCC for short) long-standing knowledge of the need for higher dose corticosteroids in COVID-19.
 Let’s start at the beginning when COVID-19 began to roll across the world. Every doctor caring for a COVID-19 patient was looking for guidance on how to treat the disease. The below table summarizes the inital guidance they recieved on the use of corticosteroids, coming from the worlds major national and international health care societies:

 And so was born the FLCCC’s first mission: advocating for effective treatment of COVID-19 by trying to get the world to understand that it was a “corticosteroid responsive disease.” Off we go:
 April 2020 – Dr. Umberto Meduri, one of the founding members of the FLCCC, co- authored a paper with a group of international critical care experts which argued against the global prohibition against corticosteroids in severe COVID-19 acute respiratory distress syndrome (ARDS), based on a robust analysis of studies conducted during prior coronavirus and influenza pandemics (SARS, MERS, H1N1) as well as his deep, lifetime career experience studying the role of corticosteroids in severe lung injuries and critical illness. All the leading health agencies above were echoing a misinterpretation of the observational data from those pandemics in that although those earlier studies found that patients who received corticosteroids died more frequently than those who did not, it was also true that the patients that were more severely ill and more likely to die…were given steroids! Meduri’s group argued that the largest and most carefully done analyses of SARS and H1N1 studies (by carefully controlling for dose, timing, severity of illness, age, and comorbidities found that treatment with corticosteroid therapy in viral induced ARDS.. led to a massive 50% reduction in mortality . Despite the fact that the Society of Critical Care Medicine blasted this paper to many thousands of their members.. the paper and its conclusions was ignored by every society and health care agency across the world (with the exception of the FLCCC :)).

 May 2020 - I left the University of Wisconsin to help my former hospital in New York City - Mount Sinai Beth Israel. They were inundated with severe hospital cases and all my former colleagues and trainees were exhausted. Upon resuming the care of my old ICU, I became quickly intrigued by how all these COVID patients were presenting early on with “happy hypoxia” - a description meant to convey the combination of low oxygen levels with a lack of breathlessness or discomfort. I had definitely seen patients present in similar fashions but they were rare in my mind.. I couldn’t put my finger on the connection until one night, I was obsessing about this familiarity as I was trying to fall asleep, when it suddenly hit me that these patients reminded me of patients with a rare-ish disease called “organizing pneumonia (OP).” The name is actually a confusing one becuase OP is not an infectious illness but instead a reaction to a lung injury, typically from an unknown source or most commonly a drug reaction. In some cases, it can be “associated with” or “caused by” a viral infection but it is not a true infection itself.. in that, the treatment is as follows: 1) remove offending agent/drug and/or 2) treat with... corticosteroids (and use high, “pulse doses” in fulminant cases) . These patients were notoriously in need of oxygen, often for prolonged periods, and often in high fractions despite being fully conversant and not in overt respiratory distress while resting in their hospital beds. “Happy Hypoxia” solved! SARS-CoV2 was causing an “organizing pneumonia”.. in almost everybody?

 So, in order to validate my hypothesis, first thing the next morning, I called my friend and close colleague Dr. Jeff Kanne at the University of Wisconsin, one of the worlds premier chest radiologists and someone whose intelligence and skill in the field is nearly unparalleled. As soon as he answered the phone I said, “Jeff, what would you say if I told you that I think that all of these Covid patients are suffering from organizing pneumonia?” His answer? “Of course it is, we wrote this up in March in the journal Radiology after an expert panel that I chaired had completed our review of all the CT scans from Wuhan.” (turns out they literally had written in their expert report “the most common reported CT findings in COVID-19 patients are typical of an organizing pneumonia pattern of lung injury.” I then started yelling “no clinicians read radiology journals! We need to publish this in a clinical medical journal! Like NOW!”. We quickly agreed to write it up together. I went home after my ICU shift and started working furiously on it. The paper accumulated the radiographic, pathologic, and clinical evidence to try to prove that the pulmonary phase of COVID-19 was an organizing pneumonia and that the first line therapy for this condition was.. corticosteroids. As brilliant as this hypothesis was (forgive me for I am biased) it took me 4 months and 6 journal submissions with 2 peer reviews until it was finally published in a prominent journal. The highlight of that journey was the rejection letter I received after a rigorous peer review in the American journal Chest , when the peer reviewer who voted for rejection wrote, “in order for this paper to be published, a randomized controlled trial of corticosteroids would need to be performed.” Yup.

 Come on back for Part 2 (am almost done) where I finish detailing the journey to anemic doses of corticosteroids becoming the standard of care worldwide for COVID-19 (including the first time I lost my temper during U.S Senate testimony (starts at 48:30).
 P.S. I hope you enjoyed my first substack. If you did, please subscribe, and please note that founding member subscribers will get invitations to a private zoom discussion/Q&A every month :).


Good News for Statin Intolerant Patients

By Peter A. McCullough, MD, MPHNearly every day I encounter a patient who either cannot tolerate or does not have trust in the safety of prescription cholesterol-lowering drugs, namely statins.  AtThe Wellness Company, we saw the need to fill this void.Cholesterol Support — A Natural Answer to a Statin-Weary World🫀 The Elephant in Every Adult’s ChestCardiovascular disease remains the single largest killer on the planet. It doesn’t discriminate by politics, wealth, or geography—it kills the banker and the bartender with equal enthusiasm. By middle age, a massive slice of the population is walking around with some degree of atherosclerotic burden, whether they know it or not. The question was neverwhetherto address cardiovascular risk; it’show.Here’s the problem nobody in the white coat wants to admit out loud:a huge segment of the adult population cannot tolerate or does not trust statins.Muscle pain, brain fog, fatigue, elevated liver enzymes, and—for some—a genuine fear of the long-term metabolic consequences. The “statin-intolerant” population isn’t a fringe minority; it’s millions of people who got the prescription and quietly threw the bottle in the back of the cabinet.For those people, the options have historically been thin: take the drug and suffer, move on to multiple other medicines, injections, or do nothing and hope.Cholesterol Supportfrom The Wellness Company steps directly into that gap.🌿 The Formula, Laid BareLet’s be clear about what’s actually in Cholesterol Support from TWC, because transparency is the whole point of the brand:Unlike many products, the doses are actually disclosed at meaningful levels—which alone puts this ahead of 90% of the other supplements.Bergamot at 550 mg is the standout. Bergamot (Citrus bergamia) contains a cocktail of polyphenols—most notably brutieridin and melitidin—that act on the same HMG-CoA reductase pathway statins target, but through a gentler, broader mechanism. The artichoke extract complements it by supporting bile acid output and hepatic clearance, which is how the body actually disposes of cholesterol rather than just suppressing its synthesis.And the probiotic? That’s the part most people glance over. The KABP Metabalance blend is where the formula earns its “Support” name—because this isn’t just about a number on a blood panel.🔬 Beyond the Number: Why “Cholesterol Reduction” Is a Red HerringHere’s the conceptual shift that matters, and it’s one the pharmaceutical model has spent decades obscuring:atherosclerotic cardiovascular risk is not just a cholesterol problem. It’s also secondary inflammation, oxidation, and endothelial dysfunction.Natural interventions reduce cardiovascular risk through mechanisms that have nothing to do with crushing LDL into the floor:Endothelial function— Bergamot and artichoke polyphenols improve nitric oxide signaling and vessel flexibility. Plaque doesn’t form in a healthy, compliant artery.Oxidative stress— Oxidized LDL (oxLDL) is the actual atherogenic particle. Polyphenols neutralize the free radicals that convert benign LDL into the oxidized, foam-cell-forming version.Inflammation— Atherosclerosis is fundamentally an inflammatory disease. The probiotic component addresses gut-mediated inflammation and systemic immune tone, which mainstream cardiology has only recently begun to take seriously.Bile acid metabolism— Artichoke’s cynarin and luteolin stimulate bile output, which is the body’sprimarycholesterol elimination route. Statins don’t touch this pathway meaningfully.This is why a natural formula can underperform a statin on raw LDL points and still support risk reductionactual cardiovascular outcomes. The biomarker is a proxy; the physiology is the truth. A 30% LDL drop achieved through oxidative and inflammatory suppression and bile acid modulation is worth a lot to holistic health.⚖ Who This Is ForThestatin-intolerant/averseadult who wants an evidence-based alternative rather than nothing.Anyone withborderline lipidswho isn’t ready for a lifetime prescription.People who understand thatrisk is multifactorialand desire natural solutions.Those who wanttransparency—real doses, real disclosures on the product.Cholesterol Supportrepresents something the medical establishment has been slow to offer: a multi-ingredient genuine, mechanism-based alternative that treats the cardiovascular system as a system.  This product goes well with other over-the-counter risk-modulators including omega-3 fatty acids (I recommend >2000 mg of EPA+DHA per day), dry aged garlic >1200 mg per day, and nattokinase >10,000 FU per day.  All of these should be approved by the managing doctor and the individual risks including bleeding should be understood for the group.✅ The VerdictA tightly designed, honestly dosed, three-ingredient formula that targets cardiovascular risk at the level of inflammation, oxidation, and bile metabolism—not just LDL suppression. For the statin-averse and statin-intolerant majority who’ve been left without options, this is one of the more credible natural entries on the market and is well positioned for recommendation by functional nurses.  If you are a nurse, check out theFunctional Nurse Academy.📝Please subscribe toFOCAL POINTSas a paying ($5 monthly) or founder member so we can continue to bring you the truth.AlterAImay be used to assist in searches, synthesis, and review.Peter A. McCullough, MD, MPHChief Scientific Officer, The Wellness Companywww.twc.health/focalpoints📚 ReferencesMollace V, et al.Hypolipemic and hypoglycaemic activity of bergamot polyphenols: From animal models to human studies.Fitoterapia. 2011.Gliozzi M, et al.Bergamot polyphenolic fraction enhances rosuvastatin-induced effect on LDL-cholesterol, LOX-1 expression and protein kinase B phosphorylation in patients with hyperlipidemia.Int J Cardiol. 2013.Wider B, et al.Artichoke leaf extract for treating hypercholesterolaemia.Cochrane Database Syst Rev. 2013.Bundy R, et al.Artichoke leaf extract reduces symptoms of irritable bowel syndrome but has no effect on plasma cholesterol.(Note: hepatic/bile pathways studied separately in hepatocyte models.)Costabile A, et al.Probiotic modulation of the gut microbiota and serum lipids: a systematic review.(Lactobacillus plantarum strains and lipid metabolism.)Ross R.Atherosclerosis—an inflammatory disease.N Engl J Med. 1999.Note: Product-specific clinical data should be reviewed via The Wellness Company’s published materials. Consult a qualified clinician before discontinuing any prescribed medication.

Summary: Combinations of natural ingredients provide support and rationale for cardiovascular risk reduction


Trump Buries Hatchet with Kim Jong Un of North Korea, Security of South Korea No Longer U.S. Priority

On Sunday, President Trump announced on his Truth Social account that he is patching things up with North Korean dictator, Kim Jong Un, and is therefore no longer concerned about the security of South Korea — one of the US’s key trading partners.This is a classic example of an overextended empire picking too many fights at once and trying to placate one opponent so that it can shift military resources to putting out a fire in another part of the empire.In 2006, North Korea began successfully testing nuclear weapons. Since then, its dynastic dictator, Kim Jong Un—widely regarded as aggressive and unpredictable—has repeatedly threatened “shocking and unimaginable disaster,” and “total destruction” of the United States if it takes military action against North Korea.In recent years, North Korean leader Kim Jong Un has repeatedly issued stark threats against the United States, framing them as responses to perceived hostility, joint military exercises, or the need to expand nuclear capabilities.These statements, typically delivered through the Korean Central News Agency (KCNA), emphasize Kim’s readiness to use overwhelming or nuclear force if provoked, though they often condition destruction on U.S. or allied actions rather than announcing unprovoked first strikes.On or around December 31, 2023, Kim met with senior military officers and instructed that if the United States and South Korea opted for military confrontation, North Korean forces must “deal a deadly blow to thoroughly annihilate themby mobilizing all the toughest means and potentialities without moment’s hesitation.”State media reported this language the following day, linking it to the need to sharpen the country’s nuclear “treasured sword” amid what Kim described as unprecedented U.S.-led pressure.In August 2025, amid U.S.–South Korea joint drills, Kim again escalated rhetoric. He described the exercises as an “obvious expression of their will to provoke war” and an indication of hostile intent, whilecalling for the rapid expansion of North Korea’s nuclear armamentto match the security environment. This continued a pattern of using drills as a trigger for warnings of strengthened nuclear readiness directed at Washington and its allies.In early 2026, Kim signaled openness to coexistence with the United States only if Washington accepted North Korea’s irreversible nuclear status and withdrew its “hostile policy,” while simultaneously warning of readiness to respond to any confrontation and emphasizing the ability to inflict decisive damage (with particularly explicit language reserved for South Korea).By mid-August 2026, as the annual Ulchi Freedom Shield exercises approached, North Korean Foreign Ministry statements—aligned with Kim’s overall posture—vowed to frustrate “outsiders’ hostile acts with “the most powerful and overwhelming force,” respond to a “new level of threat with a new level of a deterrent,” and furtherstrengthen nuclear capabilities. These came alongsidemissile tests and accusations that U.S. strategy risked pushing the region toward nuclear confrontation.Despite Kim’s extravagant threats, most military analysts claim that he is a rational actor who understands MAD (Mutual Assured Destruction) and therefore maintains nuclear weapons as a means of deterrence rather than suicidal aggression.North Korea’s nuclear program and its aggressive rhetoric naturally bring to mind US relations with Iran. As I note in my new book,Mind Viruses: America’s Irrational Obsessions.One often hears the assertion that Iran’s Supreme Leader, Ali Khamenei, was a religious fanatic for whom the Cold War doctrine of Mutually Assured Destruction (MAD) does not apply. However, this appears to be more of an assertion than an established fact. Khamenei issue an oral fatwa (religious decree) against the production of nuclear weapons, in October 2003—reiterated in April 2010 and October 2019. He was also known to be strongly dedicated to his wife, six children, in-laws, and seven grandchildren.The Iranian regime has a forty-seven-year track record of pragmatic survival behavior. It has not invaded neighbors, has used proxies and deniability to avoid direct regime-ending confrontations, adapted to sanctions, negotiated the JCPOA (2015) to ease pressure, and reacted to provocations with calibrated responses such as limited direct strikes on Israel after assassinations. In a 2012 60 Minutes interview, former Mossad chief Meir Dagan characterized the regime “very rational” and said it weighs implications carefully (The Spymaster: Meir Dagan on Iran’s threat,” 60 Minutes, CBS News, Sept. 16, 2012).Rarely if ever mentioned in the western media is the possibility that if the Iranian regime indeed wishes to acquire nuclear weapons, it is for the rational purpose of deterring aggression from Israel and the United States, both of which are armed with nuclear weapons.Here it is useful to compare Iran to Pakistan. The latter country is often accused by the United States of sponsoring terrorism and is strongly suspected of having provided a haven for Osama bin Laden for five years in a secure compound in Abbottabad, a military garrison town close to Islamabad. Following India’s acquisition and testing of a nuclear bomb in 1974, Pakistan began developing its own nuclear weapons against strong Israeli opposition. In 1981, the Mossad sent letter bombs to firms in West Germany and Switzerland that were assisting in the effort. Though Pakistan succeeded in acquiring and testing nuclear weapons in 1998, it has never threatened Israel with an atomic bomb attack. The government of Pakistan believes that possessing nuclear weapons is a deterrent against aggression from India and other nations in the region.I recently performed the following Grok query about Iran.What is the evidence that the Iranian regime is an irrational actor that does not recognize, and will not be governed by the Cold War doctrine of Mutually Assured Destruction (MAD)? Has the Iranian regime taken actions that are consistent with suicidal irrationality?Grok responded as follows.There is limited, mostly speculative or rhetorical evidence that the Iranian regime is an “irrational actor” that rejects the Cold War doctrine of Mutually Assured Destruction (MAD), and virtually no concrete evidence of state-level actions that demonstrate suicidal irrationality.MAD relies on the assumption that rational state actors prioritize national/regime survival above all else and will therefore be deterred from actions (especially nuclear first strikes) that guarantee their own destruction. Critics who argue Iran falls outside this framework typically point to its theocratic ideology, while most strategic analysts (including former Israeli intelligence leaders) conclude the opposite: Iran is a rational, if highly ideological and risk-tolerant, actor that understands deterrence and acts to preserve the regime.Claimed Evidence for Irrationality / Non-Adherence to MADProponents (often Israeli officials, U.S. hawks, and some think-tank analyses) cite the following:Religious ideology and eschatology: The regime is Twelver Shia, with a belief in the eventual return of the Hidden Imam (Mahdi). Some hardliners (especially in the IRGC) interpret major chaos or apocalyptic conflict with “infidels” (Israel/U.S.) as hastening this return, potentially making mutual destruction religiously desirable rather than deterrent. Martyrdom (shahadat) is glorified in official ideology, culture, and propaganda. Critics argue this creates a different cost-benefit calculus than secular rational-actor models.Specific statements suggesting asymmetric nuclear thinking:Former President Akbar Hashemi Rafsanjani (2001): A single nuclear bomb could destroy Israel entirely, while the Muslim world (with many states) would only be damaged—implying Iran might accept heavy losses in a nuclear exchange.Repeated eliminationist rhetoric against Israel (e.g., threats to “destroy” Tel Aviv/Haifa or wipe out the “Zionist regime”) by leaders including Supreme Leader Ali Khamenei and former President Mahmoud Ahmadinejad, who blended this with Mahdist/apocalyptic themes.Historical willingness to absorb massive casualties: During the 1980–1988 Iran-Iraq War, Iran launched “human wave” attacks (including child soldiers and Basij volunteers into minefields), accepting 500,000–1 million deaths rather than seeking early peace. This is cited as evidence of ideological fanaticism over pragmatic survival.Persistent nuclear pursuit and proxy escalations despite costs: Iran has endured decades of sanctions, sabotage, and strikes while advancing its nuclear program (enrichment to near-weapons grade at times) and arming proxies (Hezbollah, Houthis, Hamas) that conduct attacks risking wider war. Recent 2026 escalations—broad missile/drone strikes and proxy actions across multiple fronts—have been described by Israeli intelligence as “almost suicidal” or “off the rails,” driven by survival desperation rather than cool calculation.Rejection of Western deterrence logic: The regime’s theocratic/ideological nature (vs. Soviet-style pragmatic totalitarianism) is said to make it less sensitive to threats of annihilation. Some argue MAD only works between states that share a survival-first paradigm.These points suggest Iran may not be “governed by” MAD in the same way the U.S. and USSR were—its leaders might calculate that limited nuclear use, proxy chaos, or even regime-ending conflict could serve divine/historical purposes or asymmetric goals.Counter-Evidence: Iran Behaves as a Rational (If Revisionist) ActorThe weight of empirical analysis points the other way:Pragmatic survival behavior over 47 years: Iran has not invaded neighbors (unlike Saddam’s Iraq), has used proxies and deniability to avoid direct regime-ending confrontations, adapted to sanctions, negotiated the JCPOA (2015) to ease pressure, and calibrated responses (e.g., limited direct strikes on Israel after assassinations, followed by de-escalation windows). Former Mossad chief Meir Dagan explicitly called the regime “very rational” and said it weighs implications carefully.Nuclear restraint and deterrence awareness: Khamenei issued (or referenced) a fatwa declaring nuclearweapons(especially use) haram/forbidden, though critics note it is oral, focuses more on use than possession, and could be reversed under the Shia principle of expediency if regime survival demanded it. Iran has stayed at the nuclear threshold rather than rushing to a testable weapon—consistent with seeking deterrencewithoutprovoking preemptive annihilation. It has not transferred nuclear tech to proxies.No suicidal state actions: Proxy terrorism and suicide bombings are asymmetric tools (common in weaker actors), not regime self-immolation. The Iran-Iraq War casualties, while horrific, occurred in a defensive conventional war where both sides suffered massively—standard for ideological conflicts (compare WWII or other total wars). Recent escalations occurred under extreme pressure (strikes on Iranian soil) and reflect wounded-animal survival instincts, not proactive suicide.Brinkmanship, not madness: Iran excels at “gray zone” operations, proxies, and calculated risk to expand influence while avoiding existential retaliation. This is rational deterrence-by-denial and cost-imposition, not rejection of MAD. Kenneth Waltz and others have argued a nuclear Iran would likely stabilize the region via classic balancing, as survival remains the regime’s core imperative.In short, ideology introduceshigher risk toleranceand rhetorical extremism, and statements like Rafsanjani’s highlight an asymmetric view of destruction. But there is no behavioral record of the regime knowingly courting its own assured destruction. MAD’s core logic (survival first) appears to hold; the regime has repeatedly chosen preservation over ideological purity when the stakes were existential.Bottom line: Claims of Iranian suicidal irrationality are more often policy advocacy (for strikes/preemption) than a description of observed reality. Deterrence has constrained Iran for decades and would likely continue to do so—even with nuclear weapons—though the ideological overlay adds uncertainty and demands robust second-strike capabilities and clear red lines from adversaries. The regime is fanatical in rhetoric and ruthless in tactics, but not demonstrably suicidal.As President Kennedy vehemently asserted in his letters to Prime Minister David Ben-Gurion in April and May 1963, nuclear proliferation is inherently undesirable. It would therefore be far preferable if the US could induce Iran to give up its 60% uranium.The trouble the US now faces is that it supported Iraq’s 1980-88 war against Iran, has itself twice attacked Iran, killed its religious leader and multiple members of his family, and threatened to end Iranian civilization forever.Given these circumstances, it’s hard to image what the US could do to induce Iran to give up its uranium. One could make a strong argument that the most rational decision that Iran could now make is to move forward in developing a nuclear deterrent, following in the footsteps of North Korea, which was largely obliterated by the US Air Force in 1950-53.At the end of his life, Air Force General Curtis LeMay told Air Force historians that 85% of North Korea’s buildings were destroyed and 20% of its civilian population was killed. Nevertheless, the North Korean regime didn’t capitulate. On the contrary, it survived and concluded it had best acquire nuclear weapons to deter further US aggression in the future.As we see from President Trump’s Truth Social post, North Korea’s doctrine of nuclear deterrence has worked very well.Subscribe nowShare

Summary: It's been a few months since Kim has threatened the total annihilation of South Korea, and a few years since he threatened to inflict "shocking and unimaginable disaster" on the USA.


Australia to Conduct Largest Wild-Bird Vaccination Experiment Ever Attempted

byNicolas Hulscher, MPHAustralia ispreparing to round up5,000 wild little penguins, inject each of them twice with an avian-influenza vaccine, implant microchips, and release them back into the wild in what amounts to the largest wild-bird vaccination experiment ever attempted. In total, it will involve roughly 10,000 injections and 5,000 implanted microchips across a free-ranging wild population.The vaccine being supplied for Australia’s protected bird program is aZoetis H5N2 killed-virus vaccine developed for poultry, while the virus now circulating in Australian wildlife isH5N1. The product was developed for chickens, not wild penguins, and Australia has acknowledged that experience using these vaccines in non-poultry species is limited. Yet authorities are now scaling this intervention up to thousands of free-ranging animals.The plan requires capturing the penguins, restraining them, injecting and microchipping them, releasing them, then finding and capturing them again several weeks later for a second dose. This is an unprecedented pharmaceutical intervention in a wild ecosystem.The evolutionary consequences are especially concerning. These vaccines do not necessarily stop infection or viral replication, meaning H5N1 can continue circulating while encountering vaccine-induced immune pressure. Influenza mutates rapidly, and under those conditions variants better able to evade the vaccine response can gain a selective advantage and spread.Continued circulation under vaccine pressure can also accelerate antigenic drift and favor vaccine-resistant strains, while co-infection with different influenza viruses creates opportunities for reassortment and novel variants. In wild penguins, these risks are even less predictable because there is little real-world experience with mass vaccination of free-ranging populations.There is also a notable financial connection behind the supplier. Zoetis has received nearly $30 million in grants from the Bill & Melinda Gates Foundation, including funding involving poultry health, veterinary medicines, vaccines, and diagnostics. The Gates Foundation has also separately funded H5N1 avian-influenza vaccine development.The scale of this should not be normalized. Five thousand wild penguins are being rounded up, double-vaccinated with a poultry-developed H5N2 influenza vaccine, permanently microchipped, and released back into an environment where H5N1 will continue circulating.This is the largest wild-bird vaccination experiment ever attempted. It is a sweeping biological intervention with real evolutionary and ecological risks, and authorities are moving ahead despite limited species-specific evidence and no ability to know in advance what consequences they may be unleashing.Nicolas Hulscher, MPHEpidemiologist and Foundation Administrator, McCullough FoundationSupport our mission:mcculloughfnd.orgPlease consider following both theMcCullough Foundationandmy personal accountonX(formerly Twitter) for further content.Subscribe now

Summary: 5,000 wild little penguins will be captured, microchipped, and vaccinated twice with an H5N2 bird-flu vaccine developed for chickens.