Ivermectin for the treatment of COVID19 has generated a huge number of conspiracy theories, much emotion, scientific interest, research and analysis. 

It has now reached the end of the road, to become, like hydroxychloroquine, one of the enduring and dangerous pandemic myths. 

Fair comment??

I have posted on Ivermectin earlier in the pandemic here and here. There was however, one last big trial outstanding which could have changed my mind and it has finally arrived, so it’s time to look again at what has turned out to be the scandalous myth of Ivermectin.

MYTH MAKING

The idea that IVM might work for COVID19 originated in what are called in-vitro (lab) studies. They showed that very high levels of Ivermectin inhibits viral replication and had other interesting effects that require exploration. A plethora of small studies followed, some supporting its use, but most riddled with errors or fraudulent. Cherry picked meta-analyses were published by those who wanted to see it work, but were clearly biased and misleading. Conflicting views gave birth to the conspiracy that an effective treatment for a serious illness was being denied by the Establishment. 

Slowly, science caught up with the sensation. Trial after trial showed Ivermectin to have no useful effect in prevention, early treatment, hospitalisation or death. Platform trials, a novel approach to drug research during a pandemic also found no effect.

The latest and the last big trial on Ivermectin for COVID19 has finally published and this is the authors conclusion:

“This analysis from an open-label platform, randomised controlled trial of ivermectin for COVID-19 in the community suggests clinically meaningful improvements in recovery time are unlikely, with no reduction in hospital admissions, little difference in symptoms and no difference in days unwell, or impact on work and studies, at one, three, six and 12 months.”

Their findings will add to meta analyses (which add trial data together) and show no significant benefit from Ivermectin . It follows other large, placebo controlled outpatient trials COVID-OUT and ACTIV6 (low dose), and ACTIV-6 (high dose) and the TOGETHER trial. You can follow all these links, but suffice it to say they all show the same thing – IVM is sadly not effective. 

After four long years, the hope that Ivermectin was a ‘wonder drug’ that could have helped prevent or treat COVID19 is finally over.

THE FINAL NAIL?

The last trial included 2157 patients randomised to treatment with IVM, compared to 3256 given usual care. For pragmatic reasons the trial was open label – that meant that those getting IVM or placebo knew what they were getting. The patients were symptomatic with COVID19 and had a positive SARS-CoV-2 test. They were either over 65 or younger with co-morbidities. So what happened? 

Interestingly, the difference between resolution of symptoms was slightly earlier in the IVM group, but the difference in objective measures – hospitalisation or death – showed slightly worse outcome in those taking IVM. This signifies the small reported differences in length of illness were due to the well know placebo effect. There were no long term benefits of IVM.

For the vast majority of doctors, prescribers, regulators, advisors, public health doctors, GP’s and anyone else with the best interest of patients at heart, Ivermectin can go back to its place as a useful anti-helminth. The story, in reality over some time ago, is finally dead and buried.

Further, it would now be unethical to do any more studies. To do so would be a waste of time and precious resources which would add to add to the monumental amounts of time money and energy already diverted from better causes. I argue that the real scandal is that the whole IVM saga has been harmful – why? 

IVM HARMS

For one thing, there are side effects which are real, with no trace of a balancing benefit. More importantly, its use delays getting the effective help you need, detracts from getting vaccinated, and means missing the window for using genuine anti-virals. For those buying it online, there are potential problems with dosages and quality control as well as the considerable cost of online consultations offered in the USA.

The myth has generated hatred towards those who advise against it or refuse, as I would have done, to prescribe it. This is not a small matter. The irresponsible use of IVM to cash on in fear is still generating distrust of science and in healthcare workers who genuinely follow good practice. 

Advocacy of IVM for COVID has been harmful. However, I’m also pretty certain the Ivermectin myth won’t go away. Why?

THE SUPERFICIAL APPEAL OF A MIRACLE

At best miracles are vanishingly rare and when observed usually have an explanation. They appeal to emotion rather than reason. The ‘miracle’ of an anti-helminth drug working for a viral pandemic sweeping the world generated hope, many believers and more conspiracy theories than any drug ever – in other words, lots of emotion.

The Ivermectin myth particularly energised angry libertarians and the new right so dominating cyberspace. In proponents of Ivermectin they found their pandemic folk heroes – and in many sensible, pragmatic scientists, convenient enemies. There has been and remains a small but significant number of American doctors and pro-IVM organisations insinuating on their various platforms that public health doctors, regulators and researchers don’t care if you live or die.

Trials such as PRINCIPLE should put an end to all this, but they won’t. Millions of people have been subject to what I call reverse education. Huge amounts of  time and energy have been spent to end up less well informed. It is very simple to create distrust suspicion, myths and hatred, far harder to put it all into a reason based more nuanced perspective. It is far easier to destroy than to create.

Individuals and organisations like the FLCCC in America and the BIRD group in the UK have invested too much time to go away and will redouble their efforts to convince people they are right and everyone else is wrong.

SCIENCE VS SENSTATION 

Like the parrot, this myth is definitely dead!!!

In my last post I discussed the problem of lack of trust and oddly enough, those who I critique for generating distrust are all pretty much all IVM fans. It’s time for them to eat a huge portion of nutritious, well-earned humble pie. Changing minds is not a weakness, its good science to do so if the evidence changes. 

Sadly, they won’t. 


3 thoughts on “THE REAL SCANDAL OF IVERMECTIN

    1. In August 2023 the American Board of Internal Medicine informed Kory his certification was to be revoked for spreading medical misinformation.

      1. Indeed.

        He is now discredited and making a career out of public performances on so many right wing media outlets, using the persecution fallacy and meanwhile raking in $1,775 per hour (!!) for video consultations which will end up with you paying even more for drugs which are not, by any reasonable standard, effective.

        His view is that no vaccines are beneficial and that Covid can be spread by shedding through the skin after vaccination and by sex, that millions of Americans have been killed by COVID vaccines and that Tony Fauci is a mass murderer.

        To quote from his Twitter feed: “… from the smallpox vaccine myth to the polio vaccine myth to now, it is actually “pro-vaccine activism” that is the major killing force globally”

        He is a crank and should not be allowed to practice medicine.

        Kory’s egotistical musing are only convincing with a whopping dollop of observer bias, naivety and paranoid delusions of persecution.

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