The Ivermectin vs Covid Calamity

How something that is brilliant, got a job that it is probably terrible at.

The Peter Principle is an observation that in most organisations, a good employee to rise in the hierarchy through promotion until they reach a role for which they are incompetent.

This reminds of Ivermectin and Covid-19. Ivermectin is a fantastic Nobel prize winning anti-parasite drug for animals, it prevents river blindness in humans, and it is awesome.

It might have been effect against Covid. But once you look into the science it quickly becomes clear that it wasn't ever likely to work. The evidence given to supporting its use in humans is worthless, junk science.

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History of Ivermectin

Illusion

Satoshi Omura (pictured) and his team hunted for new sources of antibiotics in nature but taking thousands of soil samples from around japan and screening them for medicinal potential. They isolated a group of chemicals called avermectin from bacteria found in a single soil sample near a Japanese golf course, (1) avermectin has yet to be found in any other soil sample in the world. (2) 

Avermectin was found to be a combination of eight closely related compounds. The researchers at Merck Research Labs, a team led by parasitology specialist William C. Campbell began chemically modifying the compounds. Slightly changing their molecular structures to see if they could make avermectin more potent against parasites and safer. The resulting pair of avermectin derivatives was called ivermectin, which was 25 times more potent than existing treatments for parasitic worms. (1)


Ivermectin is effective against infestations by mites, ticks and botfly parasites that cause huge economic losses in the livestock industry. It was effective against parasites in horses, cattle, pigs, sheep and dogs, and was nontoxic to these animals.

The Nobel Prize in Physiology or Medicine 2015 was divided, one half jointly to William C. Campbell and Satoshi Ōmura "for their discoveries concerning a novel therapy against infections caused by roundworm parasites" (3)

Ivermectin the wonder drug.

River blindness, also known as onchocerciasis, is the second leading causeof preventable blindness in the world.(4,5) It is transmitted to humans from black-flies carrying the parasitic worm Onchocerca volvulus and occurs predominantly in Africa.(6)

Ivermectin underwent trials to treat river blindness in 1982 and was approved in 1987. It has since been distributed free of charge through the Mectizan Donation Program to dozens of countries.(1)

Thanks to ivermectin, river blindness has been essentially eliminated in 11 Latin American countries,(4) preventing approximately 600,000 cases of blindness.(7)

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Ivermectin vs Covid, it worked in cells?


The first thing you do to assess a drugs potential effectiveness against a novel virus, is too test it in the lab, in glass/in vitro. So you might think it is looking good for our wonder drug that when we see a paper titled:

“The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro” (8)

"However, the concentration of ivermectin they tested was 20 to 2,000 times higher than the standard dosages used to treat human parasitic infections. Such high concentrations of the drug would likely be toxic."(9)

"This is almost certainly the reason that ivermectin doesn’t work against COVID-19 in spite of its activity in vitro against SARS-CoV-2. It requires a concentration roughly 66- to 197-fold higher than is safely achievable in the blood."(10)

Hence, based on in vitro results, ivermectin was never a promising candidate as an antiviral drug to treat COVID-19. Because even after very high doses of Ivermectin, we still cannot get to a level where is concentrated enough to be effective.

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Then comes “that study

Along comes a study from Argentina, which suggest that Ivermectin is 100% effective at preventing covid.(11) As far as I can tell this is reason why ivermectin gained a lot of traction.

"The authors report that 0% of the people treated with ivermectin and carrageenan got COVID-19, while in the pilot 11% and in the full trial more than 50% of the control group got sick."(12)

So Ivermectin is the bomb, time for a trip to the vets, lets get these horse worming tablets.

First where is it from? What journal? Better research tends to get published in higher end journal. This isn’t always true, as some good journal occasional publish crap, while good science can get relegated. This journal “Journal of Biomedical Research and Clinical Investigation” only has eight papers published, and that isn’t because it only forces on very specific areas of medicine, they do anything and everything.(13)

So one red flag, but this is the first of so many red flags that we quickly lose count.

It just doesn't add up

The numbers, genders, and ages of the study’s participants were inconsistent, their totals just don’t add up. See the example here, they are only 1 off in both cases. But this is “in press” and they haven’t bothered to correct it. Which just shows a lack of care and attention. 

The graphs are very poor, and they don’t match the text. Frankly if one of my GCSE (14year old) students presented these data I would be disappointed. Definitely not what you why expect from any competent researchers. Frankly if you were making it up you could easily do better.

Other issue are the control group and intervention group are not well matched, we have no idea how they were sorted and there seems to be no blinding. This would have been pretty easy to fix at the beginning. Sort the people into two matched groups, randomly assign one group to placebo and the other to treatment. You don’t let the participants or the people giving out the medicine to know which group they are in. There you have a double blinded placebo controlled trail. Then the results would mean something, as we would have evidence to support or reject a treatment. This is very basic fundamental protocols for a medical study, and it is baffling that it hasn’t been done. Asa result we have a worthless mess of paper.

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And it gets worse...

"A hospital named in the paper as taking part in the experiments said it has no record of it happening. Health officials in the province of Buenos Aires have also said that they also have no record of the study receiving local approval."(14)

"The authors have declined to widely share his data — including with one of his own collaborators," (14) This is multiple red flags that there is something wrong with the research data, at worst this it fraud. Thankfully that is unlikely, more likely is that the study data was just motivated reasoning, bad data being miss represented.

“Given that the graphical and written representations of the primary outcome of the study appear to conflict, and the results tables differ between the pre-registration and the publication, it is worth asking whether this study even took place at all.” (14)

So this is either bad science, incompetence, or even partial to complete fabrication of data, paid to be published in a worthless journal to push... something. Whatever it is I don’t get it. there is no defending this paper.

Is there any good Science?

Thankfully yes, a Cochrane study 28 July 2021, reported:

"This updated review includes 11 trials with 3409 participants investigating ivermectin plus standard of care compared to standard of care plus/minus placebo."

"For outpatients, there is currently low‐ to high‐certainty evidence that ivermectin has no beneficial effect for people with COVID‐19. Based on the very low‐certainty evidence for inpatients, we are still uncertain whether ivermectin prevents death or clinical worsening or increases serious adverse events, while there is low‐certainty evidence that it has no beneficial effect regarding clinical improvement, viral clearance and adverse events. No evidence is available on ivermectin to prevent SARS‐CoV‐2 infection." (15)


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Another double blinded trail with 1358 patients receiving either ivermectin and placebo reported:

"Treatment with ivermectin did not result in a lower incidence of medical admission to a hospital due to progression of Covid-19 or of prolonged emergency department observation among outpatients with an early diagnosis of Covid-19.” (16)

And another well designed decentralized, double-blind, randomized, placebo-controlled trail
“We did not find a clinically relevant effect for treatment of early COVID-19 with ivermectin 400 µg/kg daily for 3 days in this large trial that enrolled over 1500 participants in the United States.” (16b)

And another
"In this randomized clinical trial of high-risk patients with mild to moderate COVID-19, ivermectin treatment during early illness did not prevent progression to severe disease. The study findings do not support the use of ivermectin for patients with COVID-19.” (16c)

What’s the harm?

"Although ivermectin has been a game-changer for people with certain infectious diseases, it isn’t going to save patients from COVID-19 infection. In fact, it could cost them their lives."(2)

Commonly reported side effects of ivermectin include
fever, pruritus (itching), and skin rash.

Serious side effects that have been reported with ivermectin include: (17)
Neurological problems (which involve the brain or nerves), such as confusion or sleepiness.
Serious eye problems, such as loss of vision.
Serious skin reactions, such as toxic epidermal necrolysis and Stevens-Johnson syndrome.
Low blood pressure.
Increased heart rate.
Liver damage.
Severe allergic reaction.

So pretty nasty all round.

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What's the worst that can happen?

“I tried it myself, but with disastrous consequences. After a six-day course of ivermectin in September 2021, I was admitted to hospital with acute eosinophilia (high levels of eosinophils, a type of white blood cell), likely due to a massive reaction to the drug. Most of my skin flaked off my body, my inguinal lymph nodes had swollen to the size of golf balls, and I was shivering constantly (known as rigors). I spent five days as a patient at the Royal Free Hospital in London, where I was treated with intravenous fluids and paracetamol. I was severely unwell. Fortunately, I recovered without lasting damage. Given this experience, I can’t recommend that anyone take ivermectin for Long Covid."

The long covid handbookThe long covid handbook on amazon USThe long covid handbook on amazon UKThe long covid handbook on Audible

“
This experience shows just how desperate Long Covid can make us. The combination of extremely poor quality of life, the unclear prognosis and the absence of any ‘official’ treatment means that long haulers (including myself at that stage) will take unknown risks if there’s some chance it might help them in any way. Because at some level it feels like there’s nothing to lose. However, it’s never worth taking risks on medication that you’re unfamiliar with if you’re not under the care of a supervising doctor. Beyond simply the doctor’s ability to prescribe, their role is to carefully consider the evidence for efficacy and safety, which should lead to a considered discussion of your individual circumstances and thus informed consent. I don’t know anyone who’s rolled the dice on a random drug and found they were suddenly cured, so don’t be tempted by social media stories that say something along those lines. There is far more risk than reward.”

The above is a direct quote from this book. It is very good and worth reading. (Although they are wrong about acupunture)

References

(1) https://www.acs.org/education/whatischemistry/landmarks/ivermectin-mectizan.html
(2) https://theconversation.com/ivermectin-is-a-nobel-prize-winning-wonder-drug-but-not-for-covid-19-168449
(3) https://www.nobelprize.org/prizes/medicine/2015/summary/
(4) https://www.paho.org/en/topics/onchocerciasis-river-blindness
(5) https://www.neglecteddiseases.gov/about/usaid-targeted-diseases/onchocerciasis/
(6) https://www.cdc.gov/dpdx/onchocerciasis/index.html
(7) https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0030371
(8) https://www.sciencedirect.com/science/article/pii/S0166354220302011?via%3Dihub
(9) https://www.nature.com/articles/ja201711
(10) https://sciencebasedmedicine.org/science-based-medicine-isnt-just-for-cam-the-case-of-ivermectin-shows-that-it-never-was/
(11) http://www.medicalpressopenaccess.com/single_article.php?refid=82
(12) https://www.buzzfeednews.com/article/stephaniemlee/ivermectin-covid-study-suspect-data
(13) http://www.medicalpressopenaccess.com/view_journals.php?jid=5
(14) https://twitter.com/GidMK/status/1419557553894137857
(15) https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015017.pub2/full
(16) https://www.nejm.org/doi/full/10.1056/NEJMoa2115869
(16b) https://www.medrxiv.org/content/10.1101/2022.06.10.22276252v2
(16c) https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2789362?fbclid=IwAR1sUf6-uuig9F7HMHubT4cjLJLdG0k_Kbe4K5J6fUdCx-I6ikg_lYK7NqE
(17) www.drugs.com/sfx/ivermectin-side-effects.html
(18) Gez Medinge and Danny Altmann - The Long COVID Handbook (2022)