Ivermectin during the COVID-19 pandemic
[1] The World Health Organization (WHO),[2] the European Medicines Agency (EMA),[3] the United States Food and Drug Administration (FDA),[4] and the Infectious Diseases Society of America (IDSA)[5] all advise against using ivermectin in an attempt to treat or prevent COVID-19.
[13] Some in vitro drug screening studies early in the pandemic showed that ivermectin has antiviral effects against several distinct positive-sense single-strand RNA viruses, including SARS-CoV-2.
[16][17] Aside from practical difficulties, such high doses are not covered by current human-use approvals of the drug and may be toxic, as the antiviral mechanism of action is believed to be via the suppression of a host cellular process,[16] specifically the inhibition of nuclear transport by importin α/β1.
[33] In February 2022, the American Journal of Therapeutics issued expressions of concern against two positive systematic reviews of ivermectin for COVID-19 which it had published in 2021, because of suspicions about the underlying data that would undermine these papers' findings of benefit.
[34][35][36] In Mexico City the government distributed ivermectin widely as a COVID-19 treatment and published the observed results on the SocArXiv archive as a research paper.
The paper was subsequently withdrawn by the archive citing concerns that it was unethical, as it effectively was an experiment carried out on people without gaining informed consent.
Philip N. Cohen of the SocArXiv steering committee said "the article is of very poor quality or deliberately false and misleading" and that its removal was justified to prevent public harm.
[50] For this reason, the World Health Organization (WHO),[49] the European Centre for Disease Prevention and Control (ECDC),[51] the Public Health Agency of Canada (PHAC)[52] and the United States Centers for Disease Control and Prevention (CDC)[53] all recommend presumptive treatment for strongyloidiasis with ivermectin in people at high or moderate risk of SHS before or in conjunction with corticosteroids in the management of COVID-19.
[49] People who were born, resided, or had long-term travel in Southeast Asia, Oceania, sub-Saharan Africa, South America, or the Caribbean are considered to be at high risk for SHS, while people from Central America, Eastern Europe, the Mediterranean, Mexico, Middle East, North Africa, and the Indian subcontinent are considered to be at moderate risk.
A legal action brought on the inmates' behalf by the American Civil Liberties Union (ACLU) was settled with the prison authorities paying compensation.
[29][70] In the United States, an analysis of prescribing data suggested the influence of political affiliation, as Republican-voting areas saw a pronounced surge in ivermectin (and hydroxychloroquine) prescription in 2020.
[8] Remarks made during the legal proceedings were misrepresented on social media to claim that the FDA had somehow reversed its position on ivermectin and COVID-19, which in reality remained unchanged.
[76] In March 2024 the FDA settled outstanding litigation and removed all social media posts that could be construed as giving medical advice and thus exceeding its statutory authority, while re-iterating that its position remained unchanged and that "currently available clinical trial data do not demonstrate that ivermectin is effective against COVID-19".
[81] In October 2021 a large network of companies selling hydroxychloroquine and ivermectin was disclosed in the US, targeting primarily right-wing and vaccine-hesitant groups through social media and conspiracy videos by anti-vaccine activists such as Simone Gold.
[13] Misinformation about ivermectin's efficacy spread widely on social media, fueled by publications that have since been retracted,[29][28] misleading "meta-analysis" websites with substandard methods,[19][83] and conspiracy theories about efforts by governments and scientists to "suppress the evidence.
[87] In the United Kingdom, retired nurse educator and YouTuber John Campbell has posted videos carrying false claims about the use of ivermectin in Japan as a possible cause of a "miracle" decline in cases.
[88] In February 2022, reports also appeared falsely claiming that the Japanese company Kowa had been able to evidence the efficacy of ivermectin in a phase III trial.
Campbell reacted by saying "I utterly despise and deny the remarks attributed to me on social media" adding that his field of expertise was not virology so he would never comment in such a way.
[96] In July 2021 Andrew Hill, a senior research fellow at Liverpool University, published a meta-analysis of ivermectin use for COVID which suggested it may be beneficial.
[97][42] However, as research fraud subsequently emerged in some studies included in the meta-analysis, Hill revised his analysis to discount the suspect evidence, and found the apparent success of ivermectin evaporated as a result.
Writing for The Guardian, Hill recounted how the revision led to him being attacked on social media as being supposedly in the pay of Bill Gates, and how he was sent photos of coffins and hanged nazis.
[85] A review article by FLCCC members on the efficacy of ivermectin, which had been provisionally accepted by a Frontiers in Pharmacology, was subsequently rejected on account of what the publisher called "a series of strong, unsupported claims based on studies with insufficient statistical significance" meaning that the article did "not offer an objective [or] balanced scientific contribution to the evaluation of ivermectin as a potential treatment for COVID-19".
Their claims are based on a narrative that Pfizer is suppressing the true benefits of ivermectin and rely on superficial correspondences between the drugs and a misunderstanding of their respective pharmokinetics.
