Page 2 | Ivermectin & India

Benediction · 03/07/2021 10:39

My dear friend's 86 year old mum was persuaded by her anti vacc children (not my friend) not to get the covid vacc. She then caught covid from one of them. They (the family) treated her with ivermectin immediately.

Three days later she was in hospital on max oxygen. Four days after that she was dead.

Benediction · 03/07/2021 10:39

This in the USA btw.

MedSchoolRat · 03/07/2021 11:57

I guess people want a wonder drug. They like ivermectin because it seems familiar & harmless. They want to believe it's great. It's off patent so relatively cheap & widely available. It is effective against many parasites so they 'believe' in this drug. Problem: parasites are not viruses. And for some reason the whole thing becomes political, people are so invested in the outcome they want.

Not as cheap & widely available as Dexamethasone.

Problem with promoting a 'harmless' drug like ivermectin, psaying that the extreme situation requires less evidence before action, is people might start to trust it rather than keep taking precautions or invest effort into finding something that is actually effective. Demand can also end up creating price rises and supply shortages that make it hard to get & use a drug for the times when it actually can help human health.

Even the original manufacturer (Merck) cdoesn't endorse ivermectin as covid treatment.

Gingernaut · 03/07/2021 13:39

@MedSchoolRat

I guess people want a wonder drug. They like ivermectin because it seems familiar & harmless. They want to believe it's great. It's off patent so relatively cheap & widely available. It is effective against many parasites so they 'believe' in this drug. Problem: parasites are not viruses. And for some reason the whole thing becomes political, people are so invested in the outcome they want.

Not as cheap & widely available as Dexamethasone.

Problem with promoting a 'harmless' drug like ivermectin, psaying that the extreme situation requires less evidence before action, is people might start to trust it rather than keep taking precautions or invest effort into finding something that is actually effective. Demand can also end up creating price rises and supply shortages that make it hard to get & use a drug for the times when it actually can help human health.

Even the original manufacturer (Merck) cdoesn't endorse ivermectin as covid treatment.

This.

New is scary. Tried and trusted is better than scary.

It's a new disease which medicine is struggling to treat because of genetic and health variables.

ollyollyoxenfree · 03/07/2021 14:00

@LemonSwan

I feel like I am in a conspiracy theory. I saw people talking about this online and went to google - thinking it was all wrong. But its wasn't. What they were saying appears to me to be right. And it just cant be.

They were saying Ivermectin prevents and treats COVID (we cant get this in the UK btw before anyone accuses me of anti-vax).

In India the Covid situation was running wildly out of control. On the 10th May they offered Ivermectin to all of the adult population. www.forbes.com/sites/siladityaray/2021/05/11/indian-state-will-offer-ivermectin-to-entire-adult-population---even-as-who-warns-against-its-use-as-covid-19-treatment/?sh=1aeac2216d9f

Then on 9th June they ban the mixture of drugs (including Ivermectin) which they were using to treat individuals in hospital.

This mixture appears to contain some of the key drugs advocated by some of the leading clinicians in Critical Care; and Oxford have added Ivermectin to their trials recently.
covid19criticalcare.com/

Now when I look at the google data it may just be a coincidence - particularly the drop in cases as it started to decline a few days before the 10th May. But what I cannot get over is the deaths jump overnight of 5000 people from 9th June to 10th June. I have looked all over for other countries who had something like this and I can only find smooth lines.
(Shown in pics - you can google 'covid in india' to see the data).

I just dont understand this. Can someone explain please because surely this just cannot be right.

Theres too many questions:
Why have I not heard about this Ivermectin before last week,
Why is no one concerned as to which drug withdrawn from treatment caused 5000 deaths overnight in India

Quite a ramble but the more I read the more I feel like I need a tin hat.

Please either pass me a hat or scrumple it up and throw the ball of foil at me.

Thanks in advance

Lot of PPs have highlighted the issues with making causal inferences from raw figures and that there's no robust evidence ivermectin is effective in treating in COVID. The Indian cocktail of drugs that is now not recommended also included HCQ and zinc (which also have no evidence for efficacy), why are you certain it was the ivermectin portion that was effective?

I'll just add that it can be good to think about why do you think "they" would want to block a drug that could save lives and prevent spread?

People mutter about how it's to drive up profits for vaccines and novel anti-viral drugs but that doesn't make any sense. Globally, a huge amount of money and effort has gone into identifying existing cheap drugs that can be repurposed to treat COVID. RCTs like solidarity and recovery have already proven efficacy of things like steroids in certain patient groups, which are now routinely used as treatments (and they're as cheap as chips).

Trials in the US and here at Oxford are still assessing if ivermectin could be useful in mild/early cases of coronavirus - I'm not sure how this fits in with the conspiracy way of thinking that ivermectin is being "banned" and "silenced" as surely you just wouldn't let trials begin in the first place if this was your aim.

I find it fascinating how those promoting ivermectin as a wonder drug are often also anti-mask, anti-vaccine and anti-lockdown (see Mike Yeadon and Simone Gold). There's certainly an agenda.

thesootherfairy · 03/07/2021 14:12

India's population is 1bn or thereabouts. There are 65mil in uk approx.

So 5000 deaths in a 1bn population is 0.0005% and around the same % per population as 350 deaths in the UK population.

Our UK death rates jumped way more than that at various points in terms of population percentage over night. Look at April 2020 with 1200 deaths a day and there was a couple of large jumps to get to that.

You're not using the correct maths here to form a picture.

You could look at Denmark and say they have not had many deaths but in terms of percentages they are similar to UK.

ollyollyoxenfree · 03/07/2021 14:19

@Hoppinggreen

Due to my work I know that Ivermectin is so effective in long Covid that Doctors won’t do a placebo trial as it’s unethical I also know that there are plans to get it licensed for UK use

@Hoppinggreen

I think there's been something lost in translation here. Ivermectin is not being used to treat long COVID and nor is there any theoretical basis for it being useful - based on it's mechanism of action it could hypothetically be helpful in the very early stages of the disease

An RCT with a placebo group (best supportive care), would be used to trial new long COVID treatments, as that's the best way you can identify if there's a causal effect. This only becomes unethical in rare scenarios where there's a clear loss of life/significant progression of severity in a placebo group - cancer drug trial are a good example. Treatment of long COVID would not fall into this category.

chesirecat99 · 03/07/2021 14:47

In India the Covid situation was running wildly out of control. On the 10th May they offered Ivermectin to all of the adult population.

No, they didn't. The state of GOA offered Ivermectin to all adults for 5 days against advice from WHO. You really ought to read your own links.

The population of Goa is only 0.1% of the population of India so even if you eradicated COVID with prophylactic Ivermectin in Goa (they didn't), it would have a miniscule effect on the number of deaths in India from COVID. You wouldn't be able to detect it on those graphs.

If Ivermectin were a successful treatment, you would expect an increase in the death rate (rather than the number of deaths) in India after the withdrawal of its use, not a 1 day spike in the number of deaths.

Hoppinggreen · 03/07/2021 17:10

Without giving too much away I sat in a meeting with a group of Doctors who were discussing how to bring Ivermectin to market to treat long Covid in The UK
Several said they were uncomfortable with placebo trials due to efficacy

MRex · 03/07/2021 17:20

@Hoppinggreen

Without giving too much away I sat in a meeting with a group of Doctors who were discussing how to bring Ivermectin to market to treat long Covid in The UK Several said they were uncomfortable with placebo trials due to efficacy

Doctors don't "bring to market" in the UK, that isn't how the system works. You're getting confused with US.

Hoppinggreen · 03/07/2021 17:23

Believe me I am not.
Doctors/scientists within Pharma cos prepare a file to submit to The MHRA or similar to seek Regulatory Approval so they can market their drug or device
It’s literally my job to do this

MedSchoolRat · 03/07/2021 18:10

alright, I'll bite.

@Hoppinggreen -- is the Rationale for Long Covid treatment using Ivermectin that somehow the virus is still active in the body, when persons have LC? Is that the hypothesis, that LC is caused by underlying chronic SARS-CoV-2 infection?

ivermectin is possibly best known for reducing malaria and other parasite transmission -- this is much more prophylaxis than treatment.

Hoppinggreen · 03/07/2021 18:23

You would have to ask the Doctors proposing to get the licence for Long Covid that, I’m not Medical and have no opinion on the efficacy personally. It’s up to The MHRA whether they feel there is a case

No need to bite though

MedSchoolRat · 03/07/2021 18:44

So you don't read the applications.

What exactly is your involvement, just taking minutes at the meeting, maybe?

Hoppinggreen · 03/07/2021 19:08

Oooh, so you did bite!
Would be great if I did - best paid minute taker around
Why is this upsetting you so much that you feel you need to attack me?
I haven’t offered an opinion, I was reporting what some Doctors said in a meeting I attended but that seems to have really touched a nerve for some reason.
I’m going out now so I hope you have a pleasant evening, maybe have a glass of wine or something and chill out

MedSchoolRat · 03/07/2021 22:01

It wasn't my intention to say anything hostile & I apologise if I came across that way.

Minute-taking is a skill I haven't trained in. Or you could have said you were a financial or contracts officer.

From what I can tell, minute-taking doesn't require you to understand the discussion, only to record the main topics & action points.

The things you're saying indicate you didn't understand the discussion. Not truly.


PRINCIPLE trial previously evaluated <a class="break-all" href="https://www.sciencedirect.com/science/article/pii/S014067362100461X" rel="nofollow" target="_blank">azithromycin</a>, and Inhaled <a class="break-all" href="https://www.medrxiv.org/content/10.1101/2021.04.10.21254672v1.full" rel="nofollow" target="_blank">budesonide</a> but I can't find their hydroxychloroquine results.

Hoppinggreen · 03/07/2021 22:11

No problem and I do appreciate the apology.
I am also unskilled in minute taking so I dont do that and I understood the part of the discussion I needed to - which was that they wanted to apply for MHRA approval.
I am procedural rather than medical

MedSchoolRat · 03/07/2021 22:20

Sounds like they are doing a bad job of explaining things, then.

If regulatory approval regimes are settling back to BAU, then your colleagues will need to write only statements that are evidenced-based.

ollyollyoxenfree · 03/07/2021 22:35

@Hoppinggreen

Without giving too much away I sat in a meeting with a group of Doctors who were discussing how to bring Ivermectin to market to treat long Covid in The UK Several said they were uncomfortable with placebo trials due to efficacy

efficacy based on what evidence?

GolfEchoRomeoTangoIndia · 03/07/2021 22:41

This has been discussed informatively on the More or Less podcast today. Well worth a listen - it’s only 9 minutes long.

TLDL: there’s a meta analysis that said it’s brilliant, but that meta-analysis is a bit suspect in its choices and over-reliant on two slightly questionable studies. There’s another meta-analysis which says it’s ineffective.

Finally, rather late in the day, some proper randomised trials are being carried out so we should have a more definitive answer pretty soon.

The fact that serious institutions are (finally) doing big properly-run trials them seems to me to indicate that
a) it’s not obviously idiotic to try the effect of an anti-parasitic drug, serious medical researchers seem to think it’s worth a look
b) there isn’t a huge conspiracy to cover up a magic cheap wonder drug

MRex · 03/07/2021 22:46

One country that's used Invermectin a lot is Peru: www.nature.com/articles/d41586-020-02958-2.

Peru happens to also be the country with the highest excess deaths in the world: www.economist.com/graphic-detail/coronavirus-excess-deaths-tracker.

I wouldn't call that correlation, because there are many other factors in the people of Peru dying at such a high rate, and because I believe there is value in randomised trials proving what works or doesn't. It's possible that Invermectin at certain dose levels could help at some disease stages, or possible it makes people worse at any disease stage. What's certain though is that there isn't currently proof that it helps, and any people self-medicating are likely to do themselves damage. That's regardless of what random poster claims to have half understood something in a meeting.

GolfEchoRomeoTangoIndia · 03/07/2021 22:50

www.bbc.co.uk/programmes/p09n6yrd
Here’s the More or Less link.

powershowerforanhour · 03/07/2021 23:49

If I had covid and was offered a choice of wormers I'd probably pick levamisole, for the potential immunomodulatory effect, rather than an avermectin - but really I'd probably just ask if they'd run out of dex.

HarveySchlumpfenburger · 04/07/2021 02:51

@MedSchoolRat

It wasn't my intention to say anything hostile & I apologise if I came across that way.

Minute-taking is a skill I haven't trained in. Or you could have said you were a financial or contracts officer.

From what I can tell, minute-taking doesn't require you to understand the discussion, only to record the main topics & action points.

The things you're saying indicate you didn't understand the discussion. Not truly.


PRINCIPLE trial previously evaluated <a class="break-all" href="https://www.sciencedirect.com/science/article/pii/S014067362100461X" rel="nofollow" target="_blank">azithromycin</a>, and Inhaled <a class="break-all" href="https://www.medrxiv.org/content/10.1101/2021.04.10.21254672v1.full" rel="nofollow" target="_blank">budesonide</a> but I can't find their hydroxychloroquine results.</div></div>
I think RECOVERY did hydroxychloroquine. Don’t know if PRINCIPLE  did as well.

Hoppinggreen · 04/07/2021 10:26

@MRex

One country that's used Invermectin a lot is Peru: www.nature.com/articles/d41586-020-02958-2.

Peru happens to also be the country with the highest excess deaths in the world: www.economist.com/graphic-detail/coronavirus-excess-deaths-tracker.

I wouldn't call that correlation, because there are many other factors in the people of Peru dying at such a high rate, and because I believe there is value in randomised trials proving what works or doesn't. It's possible that Invermectin at certain dose levels could help at some disease stages, or possible it makes people worse at any disease stage. What's certain though is that there isn't currently proof that it helps, and any people self-medicating are likely to do themselves damage. That's regardless of what random poster claims to have half understood something in a meeting.

And you are back to being nasty again. I think I clearly understood the words “I don’t think Placebo trials are ethical here due to proven efficacy” “I agree” As I have said repeatedly I DONT KNOW if that’s the case, I haven’t looked at the evidence so don’t have an opinion on it. I merely reported what some Doctors said during a meeting Why that is deserving of such vitriol I am not sure. It would be wonderful if there was a proven drug to help Covid/Long Covid and maybe it’s Ivermectin but the evidence isn’t there yet and it’s not licensed for it. Under no circumstances would I advocate self medicating