Navigating Ivermectin-related information in September 2021 can be akin to trying to cross a minefield blindfolded. If you weren’t already following the thread of news, you would find subreddits banned and quarantined, Twitter links and YouTube videos pulled down, and warnings about taking medical advice from a source that isn’t the US Centres for Disease Control or the World Health Organisation.
Into this minefield podcaster Joe Rogan has now led countless sceptics of the CDC,WHO and other public health authorities, after he revealed that he had been taking the anti-parasitic drug Ivermectin following his COVID-positive diagnosis—against the recommendations of all American public health authorities.
In an Instagram video, Rogan-who claims to reach nearly 300 million views for his podcast, The Joe Rogan Experience, revealed that following his diagnosis of COVID-19, he “immediately threw the kitchen sink” at the virus. “Monoclonal antibodies, ivermectin, z-pac, prednisone, everything. Also got an NAD drip, vitamin drip, and I did that three days in a row.”
Rogan ended his video saying he offered a “wonderful, heartful thank to modern medicine which pulled me out of this”. Instagram flagged his post with the disclaimer: “some unapproved COVID-19 treatments may cause serious harm”.
What is Ivermectin and why do public health officials advise against its use?
Discovered in the late 1970s, Ivermectin is a broad spectrum antiparasitic agent used to treat parasitic roundworm infections and diseases like onchocerciasis (river blindness), strongyloidiasis and other diseases caused by soil transmitted helminthiasis. It is also used to treat scabies.
While its use has been demonstrated to be safe in humans (with a separate variant of the drug intended for horses), it cannot be taken ad-hoc without significant risk—the US has seen a surge in hospitalisations after people took large doses in the belief that it combats COVID-19.
"You are not a horse. You are not a cow. Seriously, y'all. Stop it," the FDA tweeted after numerous reports and endorsements of the drug. By mid-August, doctors in the US were writing over 88,000 prescriptions per week for the drug, up from a baseline average of 3,600 per week, the New York Times reported citing CDC data.
As thousands of Americans go by their gut and a sense of defiance to demand ivermectin as a treatment against COVID-19, hospitals that refuse to dispense the drug have been facing lawsuits.
The belief that it helps against COVID-19 stems from several preprint studies that suggested it could inhibit the SARS-CoV-2 virus in cells in laboratory studies. However, one of the most influential studies of the drug’s efficacies—which claimed to reduce mortality by 90 per cent—was recently withdrawn from the Research Square platform after internet sleuths noted it was rampant with plagiarism and data manipulation. Ahmed Elgazzar, one of the paper’s authors, claimed he was not given a chance to defend his work—and that the plagiarism allegations were of phrases or sentences that are “commonly used and referenced”. While this was just one study out of many, its claimed high efficacy affected the results demonstrated in meta-analyses that included this one’s findings.
While some small studies have shown that the drug could help treat COVID-19, others have found no benefit. The absence of a high-quality randomised trial is one of the reasons public health agencies have not been keen on its use as a COVID-19 treatment. The drug’s own developer, Merck, publicly stated that there was no evidence to suggest it was effective against COVID-19 and self-medicating with it would be unsafe.
But many countries began deploying it as a treatment against COVID-19 anyway.
In India, states like Goa and Uttar Pradesh briefly touted it as a prophylaxis (preventative) treatment against COVID-19. However, they stopped doing so after the Indian Council of Medical Research (ICMR) National Task Force for COVID-19 and a Joint Monitoring Group decided not to include the drug in national treatment guidelines “because of lack of sufficient evidence on its efficacy based on randomised trials held in India and abroad”.
Public Health Agencies from the US, Canada, EU, Brazil and other countries all advised against using it as a COVID-19 treatment. A Senate hearing in December included multiple medical experts who cautioned members of Congress against the use of ivermectin and hydroxychloroquine against COVID-19. The World Health Organisation took the stance that Ivermectin should not be used outside of clinical trials.
Many large trials studying multiple drugs continue to study Ivermectin, including the TOGETHER Trial (testing Fluvoxamine, Metformin, Ivermectin, Interferon-Lambda and Doxazosin) and Oxford University’s PRINCIPLE trial (testing favipiravir and ivermectin).
But as the coronavirus spread in second and third waves across the world, in some places as a new and more infectious variant like Delta, despair drove many to doubt the intentions of public health agencies.
Conspiracy theories and social media censorship
A growing cacophony of voices claimed the existence of a conspiracy to prevent the use of ivermectin as a “cure” for COVID-19. Initially stemming from the US, the pro-ivermectin argument initially formed along political divides—Republicans like Sean Hannity, Senator Rand Paul and Senator Ron Johnson have all touted the drug. Deeper into the political spectrum, conspiracy theorists carved out corners of the internet to vouch for ivermectin’s efficacy. Many claim that “big pharma” stands to benefit financially from the continuation of the COVID-19 pandemic (though Ivermectin’s developer Merck is also among the largest pharmaceutical companies in the world). In online communities that were staunchly anti-vaccine, ivermectin appeared as an alternative.
Many of these corners have since been taken down, particularly on Reddit—where a sitewide protest against COVID-19 misinformation led the site’s moderators to act.
The Wikipedia entry on Ivermectin—a page likely to be the first port of call for those seeking information—has extended confirmed protection, meaning a user needs 30 days of history on the site and at least 500 edits to be able to edit it. The now-heavily edited and cross-referenced page now states in its introduction: “During the COVID-19 pandemic, misinformation was widely spread claiming that ivermectin is beneficial for treating and preventing COVID-19. Such claims are not backed by credible scientific evidence”
The result of the many misleading claims about Ivermectin as a wonder cure for COVID-19 led Google to enforce bans on such claims on YouTube. “Content that recommends use of Ivermectin or Hydroxychloroquine for the treatment of COVID-19” and “Categorical claims that Hydroxychloroquine is an effective treatment for COVID-19” could get struck down from YouTube.
For many, however, the “censorship” adds to their sense that there is a conspiracy against the anti-parasitic drug. Rogan—long associated with the anti-vaccine and anti-mask camp—has now added his millions-strong viewership to the fray.
