Critics have maligned ivermectin as a ‘horse drug,’ while supporters have held it up as a cure.
Is ivermectin a panacea, a sub-plague, or just the latest manifestation of the tendency of both parties to invent new non-issues to fight over?
As an anti-parasitic designed to help unwilling hosts rid themselves of worms called helminths, ivermectin is a Food and Drug Administration (FDA)–approved medication. It is also sometimes used to treat scabies, lice, and other such pests. As a quick fix for the coronavirus, it is not right now recommended, however. To the contrary, the FDA has released an explainer titled “Why You Should Not Use Ivermectin to Treat or Prevent COVID-19,”
“There’s a lot of misinformation around, and you may have heard that it’s okay to take large doses of ivermectin. It is not okay,” asserts the FDA, which discourages its use even in approved doses for those who test positive for COVID-19 because it “can interact with other medications, like blood-thinners,” as well as result in side effects like those often enumerated in ads for any FDA-approved drug — “headache, dizziness, even death.”
The FDA’s pronouncement on the matter no doubt comes in response to growing interest in ivermectin as a treatment for COVID-19, both for those who remain skeptical of the various coronavirus vaccines and for those who have fallen ill with COVID despite having been vaccinated. But it also comes as somewhat of a surprise considering previous government guidance on the medicine.
Ivermectin was not picked out of a hat as a potential treatment for coronavirus by the vaccine skeptics. Indeed, the National Institutes of Health (NIH) issued a report in February suggesting that it could be an effective treatment option because “reports from in vitro studies suggest that ivermectin acts by inhibiting the host import in alpha/beta-1 nuclear transport proteins, which are part of a key intracellular transport process that viruses hijack to enhance infection by suppressing the host’s antiviral response. In addition, ivermectin docking may interfere with the attachment of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein to the human cell membrane.”
In other words, ivermectin has not been randomly selected, or misidentified as an anti-viral agent by those promoting it. Even if, as the same report indicates, declarations that it is especially effective against coronavirus are at best a bit premature: “Despite this in vitro activity, no clinical trials have reported a clinical benefit for ivermectin in patients with these viruses.”
Overall, the NIH concluded at that time that “there is insufficient evidence for the COVID-19 Treatment Guidelines Panel to recommend either for or against the use of ivermectin for the treatment of COVID-19.”
Discourse around the drug heated up last week when popular podcast host Joe Rogan announced that he had tested positive for COVID-19 and promptly turned to ivermectin — among other treatments — with some success. National Public Radio reported on that by deeming ivermectin “a deworming veterinary drug that is formulated for use in cows and horses.”
Most notably, Rogan’s announcement was followed by a Rolling Stone piece erroneously alleging that Oklahoma’s hospital system was being overrun by people overdosing on ivermectin. So pervasive is this artificial epidemic, per the publication, that gunshot victims are being denied care while emergency rooms work feverishly to treat overdoses. Rachel Maddow promoted the tale along with a number of other outlets, media figures, and public health experts.
None of it is true, and Rolling Stone has since issued a correction acknowledging as much. It is, however, true that the number of ivermectin overdoses in the United States has seen a 163 percent increase from January 1 to August 31 in 2020 to the same period in 2021, and an even larger proportional increase from this July to this August — 133 cases to 459.
Even with the uptick in cases, major symptoms have been reported in only 1 percent of cases, and death in zero percent, according to the National Poison Data System.
The case against ivermectin, then, is not that it is especially dangerous when administered in drugs designed for and dosages designated for humans, but that it is inappropriate to present it as an equally effectual alternative to the vaccines, which are proven to be the best medical bulwark against infection, serious symptomatic illness, and death.
On the other hand, those promoting it — or at least those who decline to rule it out — as a treatment method argue that most people who have not yet been inoculated against the coronavirus are unpersuadable, and that at least allowing for the possibility of and researching alternative treatment methods are the best way to mitigate the effects of vaccine skepticism.
Debate over who is right and what role, if any, ivermectin can play in keeping the coronavirus at bay echoes the fights over hydroxychloroquine — another anti-parasitic medicine promoted by President Donald Trump before the advent of the vaccines — in that it’s often centered not on clinical trials and medical arguments, but cultural signaling and overwrought and improper labels such as “horse dewormer.”
What is ivermectin? Less of a medicine than of a pseudo-event in a political and health crisis full of them.