Ivermectin remains a huge deal in the US. In August, prescriptions soared 200% to almost 100,000, 20 times the pre-pandemic levels. Talk shows, right-wing propagandists and some doctors still claim that the drug is miraculously efficient. Some people have turned to more easily available veterinary formulas and deworming agents for the drughorse because they are unable to obtain prescriptions. It is dangerous, but perhaps not enough people did it to warrant unusual amounts of snarky from a federal agency warning against interspecies medication.
This confusion and misinformation has filled the information vacuum. There was no solid data available on inexpensive, reliable drugs that could be used to treat mild outpatient Covid. They were needed immediately after the pandemic. Although vaccines are a powerful weapon against the virus, most people in the world cannot afford them. There is also political opposition and structural barriers that remain in wealthy countries such as the United States. Combining that real need with snake oil grifterism, political opportunism, you get crazes such as this one for Ivermectin and the last years for Hydroxychloroquine. These crazes mostly faded after large randomized trials at the University of Minnesota and Recovery in England found no effect. Doctors stopped prescribing it. Perhaps the hydroxychloroquines' journey will serve as a model. There was much debate on both sides about whether hydroxychloroquines is a panacea or if it has safety problems. Hernandez says that everything slowed down when the Recovery trial gave a clear, definitive answer saying No, it doesn't work. This is the crisis. There isn't a national system capable of evaluating these quickly and accurately. This is what we need to answer the ivermectin questions, which includes a definitive answer as to whether it works or not.
North American trials have begun to find those answers. The adaptive multi-arm trial, called the Together trial, is an adaptive and multi-arm trial. It enrolls people continuously and uses statistical techniques that allow them to swap out drugs as they succeed or fail. The Together trial, which helped dispatch hydroxychloroquine also showed that metformin, an anti-aging drug, doesn't make much difference.
Political activists did not make metformin a rhetorical tool. Ivermectin stans are so aggressive that they make Gamergaters look chill. Mills claims that he and his colleagues were threatened and abused by ivermectin aficionados; trial designers went through the difficult process of altering the dosage to better suit the preferred fan regimen of three days rather than just one. What, seven other drugs were we able to test? We were not abused about the other drugs. Mills says that we even demonstrated one of the drugs working. His team claimed positive results for fluvoxamine. The crowd seems to not care. Ask them why they feel strongly about ivermectin. They will answer, "Because we believe there should be an affordable, effective drug that is accessible to the poor." It is available with fluvoxamine and inhaled Budesonide. Why don't they care about these drugs? They don't have an answer. They want to talk about Ivermectin.
This problem has been discussed before. Researchers and physicians have conducted hundreds of Covid-19 drug trials since the outbreak. These trials involved thousands of volunteers. Drug trials can be expensive and complicated. If taken individually, very few of these trials were rigorously designed or had enough statistical power to produce results that could be considered significant enough to improve the standard of care. Fortunately, a few did. A trial of the drug remdesivirin, partially funded by a pharmaceutical company, showed some success. The expensive monoclonal antibody (pretendered by Ron DeSantis, Florida governor) was also a hit. They must be administered by a healthcare worker. The idea of 1,000 flowers blooming was based on the local trials at each site. Hernandez said that there wasn't an integration, so it was impossible to generate guidelines-changing answers.
