The Ivermectin Mess

Scott Alexander, my favorite source for online information and discussion, has a recent post touching on the Ivermectin controversy. The point of his post, which is mostly about a Rolling Stone article that was wildly inaccurate, is that people on both sides of the political spectrum are too willing to believe whatever fits their prior beliefs. A good deal of the comment thread, however, dealt with the controversy over Ivermectin, which turned out to be interesting.

Ivermectin is a drug approved by the FDA and extensively used for treating problems having nothing to do with Covid, an anti-parasitic drug. There is some evidence that it is useful for treating Covid but apparently not very solid evidence; the FDA says it is not known to help with Covid and that studies are currently being done. True to the usual FDA policy, they disapprove of people experimenting on themselves by using it against Covid before the FDA has approved it for that purpose. Ivermectin is also used to treat animals for parasites, and some people have taken the animal version, a much larger dose, with bad effects. 

Unfortunately, the question of whether it works has somehow gotten linked to political polarization, with people on the right thinking it does, people on the left that it doesn’t. This may be connected to the controversy over vaccination, since the more people believe Covid is treatable, the less the pressure to get vaccinated. The media, not surprisingly, mostly support the left’s view. Much of the reporting is dishonest, representing it as a horse drug dangerous for humans and ignoring the fact that it is also a human drug and that the serious problems are due to people taking the animal version instead of the pill prescribed for humans. That misrepresentation can be found in a tweet, but not the web page, from the FDA. A likely result of the campaign to demonize Ivermectin is to make doctors reluctant to prescribe it even for its approved use, even more for off label use against Covid. That will make people more likely to use the veterinary version, making the problem worse, not better.

Two people in the comments responding to Scott’s piece asserted that Ivermectin had been approved by India. That got me curious, so I googled for information on the subject. The closest I could find to confirmation was a story that two states in India were using it. I then switched my search engine to Duck Duck Go and found a story, from ForbesIndia, which reported that India recommended Ivermectin in its guidelines — along with the statement that WHO and the FDA disapproved of it. I went back to Google and did the same search and was unable to find that article. There were some pro-ivermectin articles but none I found that reported that India had officially recommended the drug and none from a source that a reader, especially a left wing reader, would be likely to take seriously. This at least mildly suggests that Google filters in part on a political basis, which would be disturbing it true.

Since I raised the issue of vaccination ... . My view is that the current vaccines sharply reduce the risk of dying from Covid; I am not sure how good the evidence is that they substantially reduce infection and transmission. Common side effects appear to be minor, ranging from a sore arm to feeling sick for a few days. I therefor expect that it is in the interest of most people to get vaccinated, with the possible exception of people, especially young adults, who have already had Covid. The result of vaccination becoming a political issue is almost certainly to reduce the number of people who get vaccinated, which is unfortunate. It also produces a lot of self-righteous posturing on both sides, as became strikingly clear to me when I put my previous blog post on FaceBook.