Clinical Trials 101: A digression

 I'm going to take a break from explaining the right way to do clinical trials to say a bit about a really, terribly, awful bad way to do it. That would be homeopathy. The link is to a piece about a consumer organization that is suing CVS for putting homeopathic "remedies" on the shelf next to actual over the counter medications that might do something useful. (A lot of them don't really either but that's another story.)

First there's the question of biological plausibility. Homeopathy is radically and irremediably inconsistent with everything we know about physics, chemistry and biology. If we believe everything we have learned since the 19th Century, it's absurd and impossible. That means nobody is going to invest in high quality clinical trials of any homeopathic remedy because we already know that they cannot possibly work. 

Second, there's the issue of the placebo effect. Trials of homeopathy are small and poorly controlled (see above). We know that if we give people with some form of physical or emotional complaint an inert substance, many of them will report that they feel better. That's not necessarily bad in itself but it's definitely bad if it stops them from seeking effective treatment when they don't have a self-limiting disease, and especially bad if they have a progressive disease that is going to cause them more pain and disability and maybe kill them.

The problem is, I know this, everybody who goes to medical school or studies biology, chemistry and/or physics ought to know this, I hope you know it -- but many people passionately believe in the truth of homeopathy. I don't know about the people who manufacture these products -- maybe most of them are just con artists who are happy to take people's money. And maybe some people who buy them are just as the lawsuit alleges: deceived by their placement on the shelf in the CVS, and don't really think about it. But there are a lot of true believers.

Which brings us back to the earlier question of ivermectin and hydroxychloroquine as treatments for Covid. People believe in these for reasons other than the kind of evidence that I find convincing or even suggestive. They have reasons to believe that lie outside of the realm of empirical evidence. This is a big problem facing humanity right now because there are a lot of very important true facts that we all need to believe if we are to save our sorry asses, and a whole lot of people are choosing not to believe them. That's an emergency.