Words by Sereena Kang, Staff Writer
Misinformation surrounding the COVID-19 ‘miracle’ drug – discussing evidence for and against ivermectin.
Misinformation on ivermectin has been circulating across social media platforms with many claiming it is a miracle drug for COVID-19. Whilst others in the media push the complete opposite; using misleading language to suggest the drug is dangerous for humans and is only given to animals. In reality, there is much more nuance surrounding this complicated drug, and ultimately both sides are discussing some truths on ivermectin as well as misleading information.
Ivermectin is derived from avermectin and originated from a microorganism found in Japanese soil. It was originally used as an anti-parasitic drug for animals, but it went on to be used against tropical diseases in humans. In a surprising act of generosity, the pharmaceutical company Merck announced they would donate ivermectin tablets for free in order to combat Onchocerciasis, a river blindness disease in tropical countries. This has resulted in over 55 million people being treated with ivermectin. For the developing world, ivermectin has been a drug that has made a huge difference to the people living there.
Ivermectin was also nicknamed a “wonder drug” in a 2017 review published in Nature, well before the drug’s association with COVID-19. The review describes ivermectin as having many different capabilities from several studies including potential as an “anti-bacterial, antiviral and anti-cancer agent”. In vitro studies (studies in an artificial environment such as a test tube) on ivermectin have shown antiviral effects against several viruses such as zika and Influenza A. Essentially, the virus’s ability to replicate was inhibited.
The World Health Organisation have said they do not recommend the drug being used to treat COVID-19 apart from in clinical trials. Despite this, many have been taking ivermectin either as a prophylactic or to treat COVID-19, with some taking it as a replacement to the COVID-19 vaccine. Many people have taken the animal form of the drug, which has much stronger concentrations compared to the human form. Often when articles describe the dangers of toxicity of ivermectin to people, in relation to using the drug as a treatment for Covid, they are referring to the animal product. Centring the descriptions of ivermectin simply as a dewormer in media articles take away its importance and impact across the world for billions of people.
It is true that taking too much of the animal product of ivermectin leads to toxic effects, which has been demonstrated by spikes in calls to poison centres in America. However, the majority of the calls were from people with mild symptoms such as nausea. Ivermectin is considered to be a very safe drug, along with aspirin and penicillin. It would require taking very high levels of the drug to cause serious toxic effects. A review paper of ivermectin’s safety written by a prominent toxicologist Jacques Descotes went on to confirm this. The review concluded that “ivermectin human toxicity cannot be claimed to be a serious cause for concern” due to the high safety profile it has in many human patients. A drug with high safety and a good reputation is ideal to use as a treatment in the pandemic, particularly for countries with low access to vaccines. Ivermectin is also very cheap, which would allow poorer countries to easily obtain the drug.
Thus, its safety and cheapness would make it very useful in the pandemic — which still exists on a global scale — but the key question for doctors and scientists is how effective it truly is against COVID-19.
In certain realms of social media, misinformation encourages people to take ivermectin as a substitute over taking the vaccine. However, some of the strongest advocates for ivermectin such as physician Pierre Kory says that ivermectin or a similar cheap and readily available drug could be given as a prophylactic and would be useful in countries with sparse access to vaccines. He also argues for ivermectin being taken along with the vaccine.
However, a systematic review of the current evidence on the effect of ivermectin for COVID-19 patients was conducted independently by the Cochrane Infectious Diseases Group. It was concluded that the current evidence “does not support using ivermectin for treating COVID-19 unless they are part of well-designed randomized trials”. However, this is not a confirmation that ivermectin definitively has no significant effect against COVID-19. One key problem with the current studies available is that many of them have a small sample size and are lacking in quality. A University of Oxford trial PRINCIPLE may provide a more solid answer to ivermectin’s potential role as a COVID-19 treatment. Professor Chris Butler, a chief investigator of the trial, has said “We hope to generate robust evidence to determine how effective the treatment is against COVID-19”. This trial could be crucial in changing the current mainstream consensus on the drug, depending on what results are found. Because at the moment, there is not enough evidence to say for certain whether or not it can be used as a COVID-19 treatment. In the coming months as more studies and evidence emerges, scientists and doctors will be able to say with more clarity whether ivermectin should be used or not.