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Ivermectin continues to make headlines in the United States after COVID-19 patients and their families insist on being treated with the pest control drug. QAnon supporter Veronica Wolski, who once filmed herself confronting Staples employees about their mask policy, died Monday of COVID-19 after her supporters demanded that she be treated at the ‘ivermectin.
Wolski’s death led some of her supporters to allege that she was the victim of a medical malpractice, and the hospital where Wolski was treated reportedly sent out bomb threats.
This is not the first case of people grappling with doctors and hospital systems over the use of ivermectin, a drug that is currently not recommended to treat COVID-19. Some people have resorted to animal formulations of ivermectin, which prompted the Food and Drug Administration (FDA) to issue a warning against the practice.
But why are so many outside the medical community insisting that ivermectin works against COVID-19? Doctors break it – and the data – down.
What is ivermectin again?
Ivermectin is an oral medication that has been approved by the FDA to treat parasitic worms. Certain types of ivermectin are also used to treat head lice and rosacea. “Ivermectin is used as a ‘dewormer’ – it interferes with the nerve and muscle functions of helminths and insects,” says Jamie Alan, Ph.D., associate professor of pharmacology and toxicology at Michigan State University.
Ivermectin can also be used to treat heartworm disease, as well as certain parasites in animals, says the FDA. But it is different from the types of ivermectin that are used in humans. “People take veterinary doses, which are different in potency and strength,” says Amesh Adalja, infectious disease expert and senior researcher at the Johns Hopkins Center for Health Security. “People misuse it and that’s why we’re seeing an increase in ivermectin poisoning. They shouldn’t be taking ivermectin for COVID-19 anyway, but they definitely shouldn’t be taking ivermectin intended for animals. “
Why do so many people insist that ivermectin is effective against COVID-19?
Much of the argument for ivermectin from people outside the medical community appears to come from a lab study published in the journal Antiviral research in June. This study detailed the effect of ivermectin on SARS-CoV-2, the virus that causes COVID-19, in a lab, and found that treatment with ivermectin in cell culture caused a reduction 5,000 times of SARS-CoV-2 at 48 hours. Researchers in the study concluded that ivermectin “warrants further investigation” for possible benefit in people for treating COVID-19.
Sounds promising, right? Here is where things are misinterpreted. “Many compounds have in vitro activity against COVID-19,” explains Dr. Adalja. (In vitro, in case you’re not familiar with the term, means in the lab.) “Just because it works in the lab doesn’t mean it works in humans,” adds Dr. Adalja.
This particular lab study also used ‘very high doses [of ivermectin] that are toxic to humans, ”says Richard Watkins, MD, infectious disease physician and professor of internal medicine at Northeast Ohio Medical University. This means that you would get very sick or possibly die if you took such a high dose of ivermectin. “I guess a lot of drugs would have a similar effect,” says Dr. Watkins.
There has also been a randomized clinical trial of ivermectin in patients with mild forms of COVID-19 that has been published in JAMA in March 2021. This study analyzed 476 patients and found that the duration of symptoms of those who received a five-day course of ivermectin and those who received a placebo “was not significantly different” between the two. groups. “The results do not support the use of ivermectin for the treatment of mild COVID-19,” the researchers concluded.
The National Institutes of Health (NIH) has also weighed in on ivermectin, saying that “there is not enough evidence for the COVID-19 Treatment Guidelines Panel to recommend for or against the use of ivermectin for treatment of COVID-19. The results of sufficiently powerful, well-designed and well-conducted clinical trials are needed to provide more specific and evidence-based guidance on the role of ivermectin in the treatment of COVID-19. “
Why ivermectin is still controversial
The use of ivermectin as a so-called COVID-19 treatment has been “politicized,” says Dr Adalja. “Now people are going to believe it works no matter what the science shows,” he says. “But it’s not an evidence-based belief. People picked up something with a little bit of truth and ran with it. “
Some political leaders, like Wisconsin Senator Ron Johnson, have also promoted ivermectin as a treatment for COVID-19, a move Alan calls “bad and dangerous.”
The interest in unproven treatment is complex: “People often have deeply held beliefs about unlikely issues, and they are unwilling to change those beliefs even when they have compelling evidence. The reasons why they hold these beliefs are multifactorial and related in part to education, politics, religion, prejudice, among other factors. In the case of ivermectin, there appears to be a political base and a general distrust of scientific evidence, ”says Lewis Nelson, MD, professor and president of emergency medicine at Rutgers New Jersey Medical School.
What to do if you contract COVID-19
If you contract COVID-19, Dr. Adalja recommends talking to your doctor about your treatment options. You may be eligible for monoclonal antibody treatments, which have been shown to help reduce your risk of developing serious complications from COVID-19 if you are at high risk. If you qualify, you’ll want to start treatment “as soon as possible,” he says.
Dr Nelson adds, “There are drugs, such as antibody therapy or antivirals such as remdesivir, that may have a marginal impact on the progression of COVID when patients are not very sick, and others that help sick patients, such as corticosteroids. The best way to “treat” COVID is to prevent it with a vaccination. “
What you definitely don’t want to do is take veterinary formulations of ivermectin, Alan says. “Ivermectin can also interfere with neuronal function in humans,” she says. When given in the wrong doses, “it can cause gastrointestinal toxicity leading to nausea, vomiting and diarrhea. It can also cause nervous system dysfunction, which can manifest as hallucinations, confusion, drowsiness and coma, ”says Alan. Basically you don’t want to have to deal with this on top of having COVID-19.
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