Ivermectin now a quack cure-all

During the second and third years of the COVID pandemic, skeptics began to hear more and more of an anti-parasitic drug that had been used frequently for animals and less so for humans.

Ivermectin has been approved by health authorities to treat humans with strongyloidiasis and onchocerciasis (river blindness): conditions that are caused by parasitic worms. Also there are topical ivermectin preparations used to manage skin conditions such as rosacea and external parasites such as head lice. Used as prescribed it is quite safe and has improved the lives of countless individuals in developing nations. Yet we weren’t hearing about ivermectin used in this manner. Thanks to disinformation and irresponsible repetition of dubious claims, ivermectin was being promoted as a means to combat COVID-19.

The anti-vaccination movement embraced ivermectin because it resonated with the “my body, my choice” mantra. Right leaning media identities promoted it in much the same illogical way as they had hydroxychloroquine. It had been used safely for decades, they argued, and thus was clearly a sound choice to combat COVID-19 symptoms. Yet hydroxychloroquine, had a pharmaceutical history as an anti-malarial and an agent to manage symptoms of arthritis and autoimmune disease, not in treating COVID-19. Ivermectin similarly, had no clinically proven background in the treatment of COVID-19. The clinical trials had simply not been done.

For skeptics, the issue was and is quite simple. Look toward reputable sources. Seriously examine the arguments in favour of ivermectin. Review the strength of research being cited. Place the issue in context. Keep an eye out for ideology. Check the profiles and backgrounds of key players, and so on. In short: Seek the evidence.

Initially there was the 3 April 2020 media release from Monash University. The Monash Biomedicine Discovery Institute announced a paper published in the peer reviewed journal Antiviral Research. The title, The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro, was tantalising. An informative piece published in the Sydney Morning Herald on 22 October 2021 cites experienced drug developer Dr. Craig Rayner referring to the impact of the announcement:

“It was incredibly hyped,” Dr Rayner said. “I knew it was going to start a fire.” […]

“It’s not the best thing for Australia to become known for in terms of its contribution to the pandemic,” Dr Rayner said. “But that’s what it is, unfortunately. It has promoted vaccine hesitancy and people are dying because they’re taking a veterinary medicine that has not been proven.”

For those looking to grab the ivermectin ball and run with it, the media release was peppered with big names, other nasty diseases and potentially exciting findings. It has since been modified to include an FDA warning and offer clear disclaimers about ivermectin’s effectiveness. What mattered to those who would go on to push ivermectin as a safe cure for COVID-19, came from just a few paragraphs:

A collaborative study led by the Monash Biomedicine Discovery Institute (BDI) with the Peter Doherty Institute of Infection and Immunity (Doherty Institute), a joint venture of the University of Melbourne and Royal Melbourne Hospital, has shown that an anti-parasitic drug already available around the world kills the virus within 48 hours.

The Monash Biomedicine Discovery Institute’s Dr Kylie Wagstaff, who led the study, said the scientists showed that the drug, Ivermectin, stopped the SARS-CoV-2 virus growing in cell culture within 48 hours.

“We found that even a single dose could essentially remove all viral RNA by 48 hours and that even at 24 hours there was a really significant reduction in it,” Dr Wagstaff said.

Ivermectin is an FDA-approved anti-parasitic drug that has also been shown to be effective in vitro against a broad range of viruses including HIV, Dengue, Influenza and Zika virus.

Dr Wagstaff cautioned that the tests conducted in the study were in vitro and that trials needed to be carried out in people.

For those of us even broadly familiar with how drugs are brought to market, it was that final line above that mattered. Early lab results do not equate to clinical trials. Indeed shortly after the announcement, effort and funding across the globe was directed to clinical trials of ivermectin. Yet it would take almost eighteen months before enough studies were done, presenting enough evidence to show that ivermectin does not hold promise as a treatment for COVID-19. Over 2021, the number of news articles heavily critical of the “dubious” apparent “miracle cure” rose steadily such as here, here and here. The BBC published a powerful article on the “false science” backing ivermectin. Flawed data, fake evidence and poorly designed and written research was common.

Australia watched on as Malcolm Roberts, George Christensen, Craig Kelly and Clive Palmer promoted (and still promote) ivermectin. In the absence of evidence ivermectin could not be prescribed for COVID-19. This led to proponents sourcing and ingesting veterinary-grade ivermectin. It soon became clear from social media that many were taking excessive doses very often. On 21 August 2021 the FDA tweeted, “You are not a horse. You are not a cow. Seriously, y’all. Stop it.” That tweet links to accurate FDA information on the dangers of using ivermectin.