we’re coming up on the one-year anniversary of my original article “A New Pneumonia”, where I wrote about a strange new virus that had sickened 60 people in a place called Wuhan, China. That was Jan.7th, before anyone died or they even had a name for the pathogen we now know as SARS-Cov2.
Now, we’re heading into the winter season at 79 million cases worldwide, and 1.8 million deaths. Usually, the flu causes the most problems this time of year, but seems to be almost non-existent as people have taken personal safety precautions seriously. Still, COVID-19 is likely to continue due to its high transmission rate, and is going to be part of our lives for another year.
Most of you know me as the doctor that recommended the storing of certain fish antibiotics for scenarios where there is no longer a functioning medical infrastructure. That qualified me, in the eyes of some in the medical establishment, as certifiably insane. But my mission, after all these years, is still to put a survival medic in every family and prevent every avoidable death off the grid. For that, medics need a high level of suspicion as well as tools in the woodshed, like antibiotics for bacterial infections and personal protection gear.
We always get lots of questions about what you can do to obtain a supply of different medicines in times of trouble. For COVID-19, the latest is called ivermectin. Is ivermectin an effective option and can you find it without a prescription?
What is ivermectin? It’s a drug used in oral form to deal with parasitic infections you’ve never heard of, like strongyloides and onchocerciasis, and in topical ointment to deal with things you have heard of, like scabies, which is different, by the way, than crabs. It’s an ingredient in Heartguard for small pets and available online in a number of equine and food-producing livestock versions.
Ivermectin has recently gotten a lot of attention as a drug that could prevent the transmission of COVID-19 and treat the symptoms in those infected with SARS-CoV2. Some of the attention is positive, some negative, and it’s all reminiscent of the hydroxychloroquine controversy earlier in the year.
A number of foreign studies, like one in Australia, found that ivermectin had a good effect against SARS-CoV2 in vitro, that is, in test tubes and agar plates, and not on animals nor humans. A couple of weeks ago, results started to come more and more frequently from small studies done on humans everywhere from South Florida to Bangladesh; they all seem to confirm the potential of ivermectin against COVID.
In another study, hospitalized Covid-19 patients that received a five-day course of 12 mg daily did better than patients on placebo. The drug alone was superior to combinations of the drug given as a single dose with antibiotics like doxycycline. the five-day ivermectin group were 77 percent more likely to have viral clearance on day 14. The usual dose for ivermectin, by the way, is 0.2 mg per kilogram. One kilogram equals 2.2 pounds.
In South Florida, a study performed in the spring but released in October included 280 hospitalized patients, of which 173 received ivermectin and 107 didn’t. These were four Broward Health hospitals, one of which I rotated through a thousand years ago when I was a resident. The patients all had confirmed COVID-19; some were in ICUs and on ventilators.
Analysis of the results showed lower death rates in the ivermectin group (15.0% vs 25.2% deaths from all causes). Results were also impressive in the patients in the ICU on ventilators (38.8% mortality vs 80.7%).
So, ivermectin treatment was associated with lower mortality during treatment of COVID-19, especially in patients with severe pulmonary involvement.
Since ivermectin is FDA approved for treatment of parasitic infections and is given in similar doses in these studies, it’s relatively safe. Between 3-4 billion doses have been given worldwide, not for COVID-19, but parasites; still, that means there shouldn’t be a lot of surprises regarding side effects.
Given the results of these studies, which, I admit, are composed of only small numbers of patients, Ivermectin has developed a following in the medical community. Dr. Pierre Cory, a pulmonary specialist at St. Luke’s Medical Center in Milwaukee, gave testimony last week in front of a Senate Committee.
He said: The “data show that ivermectin is effectively a ‘miracle drug’ against COVID-19,” Dr. Kory’s a member of a group of doctors calling themselves the Front Line Covid-19 Critical Care Alliance. They’ve published a review of the research that it claims shows that not only can ivermectin prevent COVID-19, it can also improve outcomes for sick COVID-19 patients. A one-page summary of the most up-to-date clinical trials evidence supporting the use of ivermectin in the treatment of all stages of COVID-19—from prevention to serious illness, can be found online.
Now, you have to realize that professors at medical centers aren’t normally given to claiming “miracle drug” status to anything, including miracle drugs, so this is pretty interesting. As usual, the critics have been, well, critical of the ivermectin studies, claiming several flaws in the methodology. An interesting one is that the Florida study patients often received hydroxychloroqiuine and azithromycin as well as ivermectin, so there could certainly be some confusion. Other studies didn’t, however.
Despite this, The CDC has come out strongly against using any form of ivermectin against COVID-19 until more is known. It shouldn’t be a surprise that their recommendations definitely includes veterinary sources.
The perception of ivermectin as a COVID-19 remedy has mirrored that of hydroxychloroquine. That drug was highly touted as a possible treatment for COVID-19 after President Trump said in March he was taking it. The Food and Drug Administration even gave hydroxychloroquine a compassionate use authorization as a treatment for COVID-19 but later rescinded it after researchers claimed it wasn’t effective, but I believe it was the failure to include zinc in these studies that’s to blame for the less than impressive results. Once Trump came out for it, it became just another political football between right and left.
I guess the worst thing that could happen to any drug is for a politician to come out in favor of it. As for academics, they’re human too, with their own opinions, and I think they manipulate results whenever they feel it’s necessary. That’s why it’s so hard for me to do what I’m told and “follow the science”. The science is sometimes skewed to match the goals of the experts.
The critics say the studies are too small to believe. Small sample sizes can, indeed, lead to biased outcomes, but so do biased scientists, regardless of the study size. That’s my concern, and I’m hoping that more data comes out soon that shows benefits from the use of ivermectin in the near future.
With regards to veterinary sources, no veterinary ivermectin that I know of meets all of my strict criteria for medical storage. This is what I used when I evaluated fish antibiotics all those years ago:
1) it must have one active ingredient (in this case, only ivermectin). That rules out Heartguard.
2) It must be produced in human dosages (that rules out drugs made for horse and cattle).
3) It must appear identical to the human version made by at least one pharmaceutical company. Haven’t found one yet.
Of course, ivermectin exists as a human drug. It’s by prescription only, and it looks like it’ll stay that way. Ivermectin certainly has potential, and some politicians like Sen. Rand Paul of KY are formally asking for the CDC to swiftly conduct further studies into it for COVID. The FDA can issue emergency use authorization for its use. If we can keep the politics out of it, it might be an option to help save some lives.