Using animal dewormer to treat covid-19? Some think it's a great idea!

Another interesting post from PZ Myers:

Can schadenfreude kill you?

Ivermectin is used to prevent heartworm in dogs, and is used for to control other parasites in other critters, but…All these anti-vax people (some of them very vocal) are ingesting agricultural products and dying from covid-19 anyway. (surprise!) It’s a tragedy, really, because their innocent families are getting sick also.

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Unbelievably sad to hear of a 45 year old who died of Covid, leaving a wife and baby behind.

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A drug company that makes ivermectin says not to use it against COVID, due to both a lack of evidence that it is effective and lack of safety testing for that use.

Note:

  1. Drug companies make ivermectin (and other drugs touted as alternatives to the vaccine). They would profit if their products sold more. The claim that big pharma is suppressing the evidence in favor of using these is nonsensical; big pharma would profit if they were effective.
  2. This drug company is warning people not to use its product in a way that is likely to be unsafe and ineffective. It is putting public good over potential profit.
    (Of course, those reading here are unlikely to be surprised by either point; I am highlighting that this specifically goes against the conspiracy narratives in a few ways.)
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When the official FDA account is reduced to sending out tweets like this, you know the country is in trouble:

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We could inject Clorox, maybe. It’s a pretty good disinfectant.

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We do use low dose oral ivermectin for parasites in human medicine, but the level is much lower than that found to be effective against virus in vitro. (I use it only under great duress, and very rarely, as most parasites respond well to other meds, and I hate to give oral treatments for toxicity concerns). @glipsnort pointed out to me a small study that initially shows, with a higher than usual dose, some viral load decrease–but that’s not a POEM (Patient Oriented Evidence that Matters), as he would agree, I’m sure. It still has no evidence of morbidity or mortality reduction in that stage. Per Up to Date, the many studies (ClinicalTrials.gov notes in the 30s) that have been done show no strong evidence of improvement, and those that do are confounded by use of steroids that have been known to show improvement. I have relatives who follow the conspiracy theories as well about money, and I appreciate your post, @paleomalacologist

Ivermectin – We do not use ivermectin for treatment of COVID-19 outside of clinical trials, as with other interventions that are not supported by high-quality data, consistent with recommendations from the WHO [3]. Data on ivermectin for COVID-19 are of low quality. In a meta-analysis of 16 trials evaluating ivermectin (only four included patients with severe disease), the effects on mortality, need for invasive mechanical ventilation, and duration of hospitalization were all very uncertain because of limitations in trial design and low numbers of events [46]. In a retrospective review of 280 patients hospitalized with COVID-19, receipt of ivermectin was associated with a lower mortality rate; however, patients who received ivermectin were also more likely to receive corticosteroids, highlighting the potential for confounders to impact the findings of nonrandomized studies [151]. Ivermectin had originally been proposed as a potential therapy based on in vitro activity against SARS-CoV-2; however, the drug levels used in the in vitro studies far exceed those achieved in vivo with safe drug doses [152]. We reserve use of ivermectin for prevention of Strongyloides reactivation in select individuals receiving glucocorticoids. (See “Strongyloidiasis”, section on ‘Preventive treatment’.).

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The Mississippi Poison Control Center has received increased calls due to livestock or animal formulations of ivermectin taken to prevent or treat COVID-19 infection. Animal drugs are highly concentrated for large animals and can be highly toxic in humans. Do NOT take drugs made for animals in any form. If you need help, call the Mississippi Poison Control Center at 1-800-222-1222.

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Here’s my brief summary of it:

There’s a lot of discussion about a particular drug, let’s call it “wonder drug 2” or WD2 for short. Yes, there was a WD1 and yes people did take the animal version of WD1 as well with one man dying from it. Anyways…

It would be great if WD2 works at least a little bit to help with any of the following:

a) preventing infection and/or preventing symptomatic illness
b) preventing hospitalization
c) preventing death

The reason it would be great is that WD2 is relatively cheap (though the price is inflated due to high demand in some areas) and it could be sent to lower-income places and stored much easier than vaccines. It is worth doing high-quality studies on WD2 in order to determine if it has a slight benefit. But since some people want to take WD2 and recommend it to all their friends INSTEAD of a vaccine, let’s compare the two.

First, we have vaccines. They are remarkably good. For these four points they are somewhere around:

a) 60-90% effective at preventing infection/symptoms. Plus if you get infected you are infected for a shorter time and are less likely to infect others compared to those unvaccinated
b) 90-95% effective at preventing hospitalization
c) 95-98% effective at preventing death

That is… amazing! (see Science Brief: COVID-19 Vaccines and Vaccination for a list of references and more specific numbers)

So now on to WD2…

Unfortunately for WD2, a lot of the studies so far are at high risk of bias, meaning you cannot conclude much from them. There have been a few meta-analyses of WD2, but they remarkably included some fraudulent studies (as in the data was entirely fabricated-Huge study supporting ivermectin as Covid treatment withdrawn over ethical concerns | Medical research | The Guardian) and rated them as “low risk of bias.” In short, we really don’t know what WD2 actually does, but we do have some estimates (an easily digestible summary can be found here Ivermectin Shows No Clear Benefit in the Treatment of Covid-19 | by Gideon M-K; Health Nerd | Elemental). Again it would be great if it reduced mortality by 10%, that would be very helpful but we just don’t know yet.Some studies showed a large reduction in infection for those who took Ivermectin, but they are at high risk of bias for reasons you can look at here: https://www.psmid.org/wp-content/uploads/2021/04/Ivermectin-Prophy-v2_1619527505.pdf. Or we have some high-quality studies showing things like Ivermectin did nothing to reduce hospitalization and people in the Ivermectin arm ended up on mechanical ventilation sooner than placebo (Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19) a randomized, double-blind, placebo-controlled trial | BMC Infectious Diseases | Full Text).

Please do not use it as a substitute for getting vaccinated. That is all, thank you.

I made this little chart as well:

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Ivermectin is a dewormer for humans as well as animals. Of course, a human would not want to take a horse dose, nor use it to treat epilepsy or Covid or depression. Just use as intended and as prescribed.

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Good comparison. I have a nephew who just went into the hospital. Had been treated at home with the usual anti-vaxxer potions. Prayers for him and family.

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It’s sad, and, please bear in mind, the other side of the culture war does stuff that is equally worthy of consternation. And there is something of a horseshoe connecting acolytes at each extreme.

It’s very tempting to simply judge all players, on both sides, and I often do, and then have to apologise to God.

I would really love to understand why this is happening.

I suspect a key factor is trust. Have the people ever or anywhere, trusted hegemony? We have an idea they did, but perhaps that’s because history is written by the victors.

The rise of scientific knowledge, uniquely trustworthy and authoritative, is something very new. Perhaps these are teething pains while culture and power battles adjust to that. Only, teething pain isn’t often fatal…

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