Drugstore and pet food store sales of ivermectin on the rise despite inconclusive studies on efficacy against COVID-19
In his book “Summer of ’49,” David Halberstam told the story of Boston Red Sox manager Joe McCarthy’s efforts to reform a talented but troubled pitcher whose drinking bouts made him unreliable.
McCarthy brought the player into the clubhouse where two glasses – one filled with water, the other with whiskey – were set on a table. McCarthy dropped an earthworm into the glass filled with water. The worm swam without any ill effects. Then he dropped a worm into the glass of whiskey. The worm quickly sank to the bottom of the glass, dead.
“What does that tell you?” McCarthy asked.
The player thought about the demonstration for a moment, then replied, “If you drink whiskey, you won’t get worms?” “
Halberstam’s story of someone drawing the wrong conclusion may be humorous, but in recent weeks, a phenomenon – the use of a drug most often sold as a dewormer for cattle that has been hailed as an alternative to the COVID-19 vaccine or a treatment for the virus – has raised concern among healthcare professionals.
Take ivermectin and you won’t get worms, but you can still get COVID-19 and its severe symptoms, according to health experts.
Ivermectin is a medicine used to kill parasites in animals and humans. It is most often used as a dewormer for horses, cattle, and pigs, but it is also prescribed for human use to control other parasites.
“The most common use is for bedbugs,” said Dr. Emily Landrum, who practices family medicine at the Starkville Family Clinic. “I prescribed ivermectin, but not very often.
In recent weeks, demand for ivermectin has exploded after reports revealed the drug had been studied as a treatment for COVID-19.
In the past month, in particular, ivermectin has been flying off the shelves of drugstores and farm supply stores.
“Normally I stock a box of ivermectin,” said Chris Bonner, owner of Chris’ Pharmacy in Columbus. “Now I’m ordering a dozen, 18 boxes at a time, and I’m always hungry. “
The human form of Ivermectin is only available with a prescription, but no prescription is needed to buy Ivermectin used for animals.
“I started seeing people buying it for COVID in January,” said an agricultural supply official who agreed to speak on condition of anonymity because he realizes the drug can be controversial. “It really accelerated over the last four or five weeks, around the time we started hearing about the Delta variant. Compared to last August, my sales of ivermectin have probably increased by 50. “
Bonner notes that the purchase of animal medicine for human use is illegal.
“There is no punishment for it, but if you get sick after taking animal medicine you have no liability claim,” he said. “You’re all alone. It was your decision.
Study finds insufficient evidence for ivermectin
Although ivermectin is not approved by the FDA for the treatment of COVID-19, its use became popular after some studies indicated that it was safe in patients with SARS-COVID-2 and that symptoms were reduced. Some of these studies have suggested that ivermectin may be useful in treating patients with mild symptoms of COVID-19.
However, an analysis of 14 such studies, published at the end of July by Cochrane, a London leader in the compilation of medical data, found insufficient evidence of the benefit of ivermectin.
According to the Cochrane report:
“The authors of this Cochrane systematic review found no evidence to support the use of ivermectin to treat or prevent COVID-19 infection, but the evidence base is limited. Evaluation of ivermectin is continuing in 31 ongoing studies.
“The lack of good quality evidence on the efficacy and safety of ivermectin stems from a group of studies that mainly consists of small, insufficiently potent randomized clinical trials with limited overall quality in terms of design. , the conduct and notification of studies. Current evidence does not support the use of ivermectin for the treatment or prevention of COVID-19, unless it is part of well-designed randomized trials. “
The public health officer intervenes
Until the end of last week, health officials were slow to address the use of ivermectin to fight COVID-19.
Asked during his weekly COVID briefing on doctors prescribing ivermectin as a treatment for COVID-19, Mississippi state health official Dr. Thomas Dobbs was reluctant to criticize them.
“First of all, if a doctor thinks it’s the right thing to prescribe (ivermectin), we don’t want to interfere with the doctor / patient relationship,” Dobbs said. “If a doctor wants to use it, we leave it to their discretion. It is an evolving situation with different treatments used. Personally I don’t think it will work, but if you get ivermectin please get antibodies as well. We know that monoclonal antibodies work. So if you get COVID, don’t let it be ivermectin or… Let it be ivermectin and antibodies. “
The farm supply store manager said he first realized people were buying ivermectin to treat COVID-19 in January.
“I’ve been taking it since January after seeing retired doctors and vets taking it,” he said, noting that he received the Johnson & Johnson vaccine in March and was using ivermectin as supplement to the vaccine.
“I haven’t had any side effects,” he said, noting that he’s taking the dosage recommended for pigs.
The Ministry of Health issues an alert
There is growing concern that many people take ivermectin in much higher doses, primarily among those who purchase the drug from farm supply stores.
The state’s health department issued an alert on Friday after the Mississippi Poison Control Center reported receiving an increasing number of calls from people potentially exposed to ivermectin. At least 70 percent of the calls involved livestock or animal formulations of ivermectin purchased from livestock supply centers. Eighty-five percent of the callers had mild symptoms, but one person was asked to seek further evaluation because of the amount of ivermectin allegedly ingested.
The state’s health department confirmed on Friday that a person was hospitalized in Mississippi after ingesting ivermectin.
In its alert, the health department asked healthcare providers, doctors and hospitals who identify patients with illnesses related to ivermectin ingestion, whether they are prescribed preparations or for livestock, to contact the poison control center.
The incidents of high-dose ivermectin are linked to studies that have shown the drug to be effective against COVID, Dobbs said.
“If we look at the biology of (ivermectin), the concentrations we see in vitro that have shown efficacy against the virus were 50 times higher than what can be achieved in humans under safe conditions,” Dobbs said. . “I doubt it will be very effective when taken in doses that are safe for humans.”
“I absolutely would not prescribe it”
While there is no doubt that prescriptions for ivermectin have increased dramatically, Landrum believes that most of these prescriptions are not written by doctors.
“I absolutely wouldn’t prescribe it as a COVID treatment,” Landrum said. “I’m not sure, but I believe most of these prescriptions are written by nurse practitioners in emergency care facilities. I would just hate to think that they mostly come from doctors. We have two safe and effective options: vaccines to prevent COVID and monoclonal antibodies if you have the virus. I don’t see any reason why ivermectin would help.
Bonner said he was dismayed, but not surprised, people were asking questions about ivermectin as an alternative to COVID vaccines.
“I don’t mind telling people what I’m thinking,” Bonner said. “I tell them to get vaccinated. But that’s not what they want to hear.
While Dobbs is skeptical of ivermectin’s effectiveness against COVID-19, he is certain of one thing:
“Please, please, please don’t buy it from a grocery store,” he said.
Slim Smith is a columnist and editor for The Dispatch. His e-mail address is [email protected]