Ivermectin for covid-19 – the highlights

Ivermectin is an effective antiviral agent with a long record of successful use in human and animal parasite infestations. Its value as part of the early treatment for covid-19 was evident by December 2020. However, what followed was not widespread use but years of misleading claims, controversy and obfuscation.  In some countries ivermectin was used with excellent results and it remains a flagship example of a repurposed drug that provided a cheap and effective early treatment option for covid-19.

To mark World Ivermectin Day (29^th July 2023), in this article and videos we chart some of the highlights of the ongoing story of ivermectin use for covid-19.

In December 2020 a group of experienced intensivists (Professor Paul Marik, Dr Pierre Kory and Professor Joseph Varon) in the USA took the unusual step of holding a press conference and live streaming it to the world. The purpose was to describe experiences of using ivermectin to treat covid-19 infection and to issue a call to action to health authorities around the world. The message was clear – ivermectin hastens recovery and reduces mortality.  The pathway out of the pandemic seemed clear.

In January 2021 a rigorous, independent meta-analysis of ivermectin studies by Dr Tess Lawrie showed that there was an 83% reduction in the risk of death with ivermectin and this was graded as ‘moderate certainty’ evidence.  “The uncertainty is not related to whether or not ivermectin prevents death, but the estimate of effect size. We know  …..  it prevents death; the only uncertainly is by how much”, she emphasised.

In February 2021 Dr David Scheim described the mass treatment of the population in Peru with ivermectin. One state had started much later than the others and provided a natural control. This approach was associated with a 75% reduction in excess deaths by 30 days.

The next logical step was to interview a practising frontline clinician so that we could hear how ivermectin treatment is prescribed and managed in everyday practice. In a vivid and often moving interview Dr Jackie Stone in Zimbabwe described her experiences of ivermectin both as a clinician and patient.

In May 2021 IMI interviewed Dr Suryakant, a practising pulmonologist and adviser to the Indian Government. He is a strong advocate of mass prophylaxis with ivermectin and described in detail how ‘test, trace and treat’ schemes work in India. Dr Suryakant is based in Lucknow in Uttar Pradesh, a state that has been using ivermectin since August 2020 and contained and reduced the spread of SARS-CoV-2 very effectively.

In February 2023 Professor Colleen Aldous (Professor for Medical Research, University of KwaZulu-Natal, South Africa) explained why the SAIVE trial provided the highest quality trial evidence for ivermectin so far. She also argued that the pandemic could have been over sooner had the available evidence been evaluated correctly. “We should have been looking at the totality of evidence just as David Sackett – the father of evidence-based medicine – wanted it to be. Never once did he say a randomised, controlled trial was the gold standard – but you’ve got to look at the totality of evidence”, she said.

For more information and stories about ivermectin, see the World Ivermectin Day website.