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Maybe either MacReady or Childs (or both of them) were already copies at the end and they just didn't know it.
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Or on the other hand they could have both been "Things" and knew it, but each didn't know if the other was human or another "Thing". Hell, all the humans could have been gone by half way through the film and the rest was just a bunch of "Things" trying to outwit each other. Now
that's paranoia!