Why the Obsession with Ivermectin?
The quacks sure seem to love ivermectin. But why the fixation on this specific drug in the first place?
With the recent outbreak of hantavirus on a cruise ship, a number of people in the woo-industrial complex have already talked about using ivermectin to treat it. As always, this is absolutely goofy, given ivermectin is an anti-parasitic that is largely ineffective against viruses. At best, it blocks viruses from entering the cell nucleus, though the dosages required to do so effectively would be toxic. Furthermore, COVID-19’s reproduction uses the cell’s ribosomes, never needing access to the nucleus in the first place. So why are all these people obsessed with it?
Turns out there is a fairly simple explanation — though not one that supports its efficacy as an antiviral. Though many people with only surface-level knowledge decry it as a “horse dewormer,” given the popularity of apple-flavored horse ivermectin formulations as a way for the ivermectinites to acquire the drug without going through the medical system, it is a critical drug for humans in many countries.
Especially critically, ivermectin is a fantastic treatment for infection with strongyloidiasis, a parasitic worm very common in poorer countries with warm climates. In rural parts of the countries, infection rates are estimated to be around fifty percent! In most cases, the worms only cause mild symptoms. For most people infected, they only cause occasional, mild-to-moderate digestive issues that can easily be mistaken for something like irritable bowel syndrome. The worms live in the intestine, subsisting off of nutrients eaten by their human host, though not enough that, under normal circumstances, nutritional problems arise.
However, in a severe medical crisis, even a relatively benign parasitic infection can tip the scales, given the presence of the worms does inflame the immune system and rob the body of vital nutrients. Furthermore, corticosteroids — often given in cases of severe upper respiratory infection like COVID — make it easy for a strongyloidiasis hyperinfection to develop, where the worms overwhelm the body’s defenses and cause far worse symptoms.
Given the risks such parasites pose for hospitalized patients, it makes sense for countries with widespread worm infections to give their patients dewormers, and ivermectin is a highly effective, well-tolerated choice. This leads doctors in these areas to regularly use the drug and ascribe a high value to its efficacy in treating patients.
Because of this, in these countries, papers are routinely published that compare the prognoses of patients who were and were not administered ivermectin when hospitalized. Given the complications that parasitic infections like strongyloidiasis create and their prevalence in these areas, unsurprisingly, patients who were given ivermectin often fare significantly better than those who were not.
This is where the breakdown in understanding occurs: rather than being understood as successfully treating other conditions that are prevalent in the parts of the world producing these studies, the improvement in prognosis is attributed to ivermectin treating the disease itself. Though most of the ivermectinites likely do not have that deep of an understanding of what drives the phenomenon, key influencers in that part of the woo-o-sphere push the drug due to this misunderstanding. However, when ivermectin is seriously studied in developed countries, the supposed benefits are never replicable, because parasitic infections are uncommon.
The real takeaway here is that, if a particular type of treatable condition is prevalent in a given area, treating that is often valuable even when it is not the problem bringing the patient to the hospital in the first place. A COVID patient who can get proper nutrition, lacks other sources of immune system inflammation, and does not risk experiencing parasitic hyperinfection from steroids is substantially more likely to survive.
Ivermectin is a miracle drug — for parasites. Parasitic infections often interfere with the successful treatment of other conditions, so it’s good to treat them when there is good reason to expect they might be present, which simply is not the case for the vast majority of patients in the United States. Be grateful to live in a developed country and focus on treatments with more robust evidence.