Ivermectin remains news in the United States after patients with COVID-19 and their loved ones insisted on being treated with the antiparasitic drug. QAnon supporter Veronica Wolski, who was once filmed confronting Staples employees over her mask policy, died Monday of COVID-19 after her supporters demanded that she be treated with ivermectin.
Wolski’s death led some of his supporters to allege that he was the victim of medical malpractice and, according to reports, the hospital where Wolski was treated has dropped bomb threats.
This is not nearly the first case of people struggling with doctors and hospital systems for the use of ivermectin, a drug that is currently not recommended to treat COVID-19. Some people have resorted to asking for formulations of ivermectin in animals, which has led the Food and Drug Administration (FDA) to issue a warning against the practice.
But why do so many people outside the medical community insist that ivermectin works against COVID-19? Doctors break it down and the data.
What is ivermectin, again?
Ivermectin is an oral drug that has been approved by the FDA to treat parasitic worms. Some 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,” explains Jamie Alan, Ph.D., associate professor of pharmacology and toxicology at Michigan State University.
Ivermectin can also be used to treat heartworm diseases, as well as certain parasites in animals, the FDA explains. But this is different from the types of ivermectin used in people. “People take veterinary doses, which are different in terms of potency and strength,” says infectious disease expert Amesh Adalja, MD, a scholar at the Johns Hopkins Center for Health Security. “People misuse it and that’s why we see an increase in ivermectin poisoning. They shouldn’t take ivermectin for COVID-19 anyway, but they should definitely not take ivermectin for animals. “
Why do so many people insist that ivermectin is effective against COVID-19?
Much of the argument for ivermectin in people outside the medical community appears to be derived from a laboratory 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 laboratory setting, and found that treatment of ivermectin in a cell culture caused a 5,000-fold reduction in SARS-CoV-2. at 48 hours. The study’s researchers concluded that ivermectin “justifies additional research” to obtain a possible benefit in people to treat COVID-19.
Sounds promising, right? This is where things get misunderstood. “Many compounds have in vitro activity against COVID-19,” says Dr. Adalja. (In vitro, in case you’re not familiar with the term, it means in a lab environment.) “Just because it works in a lab environment doesn’t mean it works in humans,” Dr. Adalja adds.
This particular laboratory study also used “very high doses [of ivermectin] which are toxic to humans, “said Richard Watkins, MD, an infectious disease physician and professor of internal medicine at Northeast Ohio Medical University. ivermectin “I guess a lot of drugs would have a similar effect,” says Dr. Watkins.
A randomized clinical trial of ivermectin was also published in patients with mild forms of COVID-19 JAMA in March 2021. That 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 Panel of Treatment Guidelines to recommend for or against the use of ivermectin for COVID-19 treatment. The results of appropriate, 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 treatment called COVID-19 has been “politicized,” says Dr. Adalja. “Now, people will believe that it works regardless of what the scientific data show.” belief that it is based on evidence. People have taken something with a little element of truth and run into it. “
Some political leaders, such as Wisconsin Sen. Ron Johnson, have also promoted ivermectin as a treatment for COVID-19, an action Alan calls “incorrect and dangerous.”
Interest in unproven treatment is complex: “People often have deep beliefs about issues that are unlikely and are unwilling to alter those beliefs even when they are provided with incontrovertible evidence. The reason they hold these beliefs is multifactorial and is related in part to education, politics, religion, bias, among other factors. In the case of ivermectin, there seems to be some political basis 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 hire COVID-19
If you are taking COVID-19, Dr. Adalja recommends talking to your doctor about your treatment options. You can opt for monoclonal antibody treatments, which have been shown to help reduce the risk of developing serious complications of COVID-19 if you are at high risk. If you qualify, you will want to receive treatment “as soon as possible,” he says.
Dr. Nelson adds: “There are medications, such as antibody or antiviral treatment such as remdesivir, that can have a marginal impact on the progression of COVID when patients are not very ill and others that help sick patients. , such as corticosteroids. The best way to “treat” COVID is to prevent it with vaccination. “
What you definitely don’t want to do is take veterinary formulations of ivermectin, says Alan. “Ivermectin can also interfere with the function of neurons in humans,” he says. When administered in the wrong doses, “it can cause gastrointestinal toxicity that causes nausea, vomiting and diarrhea. It can also cause nervous system dysfunctions, which can appear as hallucinations, confusion, drowsiness and coma, “says Alan. Basically, you don’t want to have to deal with this in addition to having COVID-19.
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