I want to talk about ivermectin. Ivermectin is one of many medications. I wanna be careful with my words. Ivermectin is one of many medications that for quite some time has been suggested as a possible prevention or treatment of and for COVID. 

Now there’s a bunch of these that were mentioned early in the pandemic. Hydroxychloroquine, ivermectin, the antibiotic azithromycin, taking zinc, taking vitamin D and on and on. And what all of these have in common is that they’re cheap and widely available. 

So first and foremost, there’s no problem assuming that it can be done safely of testing widely available medications when you have a novel virus against which we have no vaccine and no treatment, which was the case early on. 

There’s nothing inherently wrong with that. 

And one of the things that we, in general, want to do is we don’t wanna speak in absolutes.

We don’t wanna say things like there is no way Hydroxychloroquine will ever be shown to work for COVID. No, no, no, no, no. 

We, that’s a predictive statement. We can’t predict the future. 

What we want to focus on is do we have empirical evidence today that these medications versus nothing or the standard of care at the time, if it’s a medication rather than prophylaxis, do they work better? 

And one of the things we’ve learned now, thanks to good science is that vitamin D does seem to, for example, have a protective effect in general, when it comes to viral infections, and this applies to COVID.

There was the idea early on, we’re seeing some interesting data when it comes to vitamin D levels and okay, we’ve determined it seems that vitamin D to maintain a normal, healthy level of vitamin D has a broadly protective effect against viruses, including COVID. Great vitamin D’s cheap.

We learned it. 

When it comes to ivermectin for a long time, we didn’t have good science. We didn’t have good data until we did. And in mid February, there was a study published called Efficacy of Ivermectin Treatment on Disease Progression Among Adults with Mild to Moderate COVID-19 and Co-morbidities. 

And this study, which was an actual randomized controlled trial – that’s the gold standard – you take a treatment, and you compare it to the standard of care and see what the outcome is, making both groups, equivalent, and adjusting for differences in the groups in each arm of the trial. 

That peer-reviewed, properly done study found that ivermectin does not reduce death when taken for mild to moderate COVID-19. 

That’s a great study. Unfortunately, since that, there have been a number of attempts to rehabilitate, older studies to claim that COVID does respond to a treatment with ivermectin. 

And unfortunately, both of the main studies cited have significant flaws. One such study, and I hesitate to even call it a study because it’s really just a conference abstract, that’s all it is. One, one such abstract appeared to find a 70, 70% reduction in the rate of death among patients given ivermectin compared to those given remdesivir. 

This was published in the abstracts from the Eighth International Meeting on Emerging Diseases and Surveillance in November of 2021. 

And everybody from Jordan Peterson to Dr. John Campbell, who’s not a medical doctor, I don’t say that as an attack, I’m just telling you, he’s not a medical doctor, initially praised this and said, wow, 70% reduction in death. Dr. John Campbell has since removed his video all together on this and said that he was wrong. I don’t even know Jordan Peterson, what he knows is going on.

But one of the authors of that study, Iakov Efimenko, came out and said it’s being, being misinterpreted.

This was presented in November, based on even older data. We have an actual R C T from February that we can look at. And all that that study or abstract did was look retrospectively at data about people given ivermectin.

It did not, first of all, it did not account for disease severity. It’s completely plausible that the people given remdesivir were much more seriously ill than those given ivermectin, which would tell us why that group might be more likely to die. 

The study slash abstract did not stratify the participants based on vaccine status. It could be that the people that got Remdesivir got it because they were sicker because they were more likely to be unvaccinated. And it’s not actually about remdesivir or ivermectin.

So the author of the study said it’s being misused. It doesn’t suggest ivermectin should be used to treat COVID. And we now have newer data, the study I mentioned earlier.

So that’s one, and it does not tell us ivermectin works. 

The second study that is being pointed to now is one called ivermectin prophylaxis used for COVID-19, a citywide perspective, observational study of 223,128 subjects using propensity score matching. 

Unfortunately, this study also has significant issues. One of the problems is that this is a study from Brazil.

And one of the things that was done was people were given ivermectin to take prophylactically. But the study doesn’t actually confirm who actually took ivermectin. A bunch of people were given ivermectin and told, take this, but it’s not actually clear who took ivermectin and who did not. That alone makes this not the most rigorous type of study.

There were also some questions about conflicts of interest among the authors, which appeared in the earlier version of the study, but were not disclosed in the eventual published version of the study. 

So again, it is not the gold stand of a randomized, controlled trial nor of a double blind, randomized controlled trial. We don’t even know which participants actually took the ivermectin. 

So I have no problem exploring whether every substance on earth might be good for treating COVID. I have no ideological problem with Hydroxychloroquine or ivermectin or whatever, but we’ve gotta be really careful about what quote studies we pay attention to. And the two that are now being bandied about are not good studies. 

They’re not even really studies by the, the strictest sense, and the one we should be paying attention to is the R C T published in February of 2022 on the efficacy of ivermectin for mild to moderate COVID.