There are now more than 20 countries on the planet that are using the off-patent anti-parasite drug against Covid-19.
Doctors in India, the world’s second most populous country, are locked in an epic, gruesome battle against SARS Cov2. The country currently accounts for half of the world’s cases. Many cities are running out of hospital beds. As happened in Mexico and Brazil just a few months ago, medicinal Oxygen has become dangerously scarce and is being sold on the black market at extortionate prices. As of last week fewer than 10% of Indians had received even one dose of a vaccine. Just 1.6% are fully vaccinated, according to a New York Times database — even though India is producing two vaccines on its own soil and is home to the world’s biggest vaccine manufacturer.
This time around, India’s government has spectacularly failed to contain the spread of the disease, largely due to its own complacency. Many doctors are prescribing Remdesivir despite the medicine’s high cost and lackluster performance in clinical studies and unproven safety record. There has been a surge in black market sales of the drug as people have rushed to try to secure it, leading to a crunch in its supply. A single vial can go for Rs30,000 — ten times the official retail price.
Desperate Times, Desperate Measures
As Jerri Lynn reported on Sunday, the huge uncontrolled wave of infections hitting India is having all sorts of implications for the Modi government. In its desperation to regain control of the virus, India’s government quietly changed its treatment guidelines last week. The new guidelines include the option of prescribing two repurposed medicines for mild Covid patients: budesonid and ivermectin. The former is an inhaled steroid that has been shown to reduce the time to recovery and need for urgent medical care. The latter is an off-patent anti-parasitic that has been discovered to have powerful anti-viral and anti-inflammatory properties.
India is no stranger to ivermectin. The medicine has been used as an anti-parasitic for decades. It has also been used in the fight against malaria. Two of its regions, Uttar Pradesh (population: 230 million) and Bihar, have been using the medicine since August, to dramatic effect. By the end of 2020, Uttar Pradesh (UP) — which distributed free ivermectin for home care — had the second-lowest fatality rate in India at 0.26 per 100,000 residents. Only the state of Bihar, with 128 million residents, had less.
But Uttar Pradesh (UP) did more than treat 300,000 mild cases at home through 2020; it also used ivermectin as a prophylaxis. COVID response teams began taking the drug and hardly any of them caught the illness. A similar occurrence was reported in a study of frontline critical care workers in Argentina. U.P. then had contacts of COVID patients take it, with similar success. “Recognizing the sense of urgency,” Amit Mohan Prasad, a U.P. health official, wrote in a Dec. 30 article, “we decided to go ahead.”
Yet UP’s remarkable success at bringing the virus under control did not inform national policy — at least not until now. The Indian Council of Medical Research declined in October to recommend ivermectin nationwide, citing, like so many health regulators, the need for more data. But all that changed last week as India became the biggest country on the planet to adopt nationwide use of ivermectin against Covid-19.
A Growing List of Countries…
More than 20 countries are now using ivermectin to treat Covid-19 to one degree or another, with promising results, despite the fact the World Health Organization has not approved its use. They include Mexico, Guatemala, Argentina, Brazil, Bolivia, Slovakia, the Czech Republic, Portugal, Nigeria, South Africa and Egypt.
Ivermectin has a known safety profile, as a well-tolerated life-saving drug that has been prescribed almost four billion times since the 1980s. In 2015 its creators won the Nobel Prize for Medicine (for more information read my previous article, It’s Time to Talk About Ivermectin).
Large “natural experiments” in regions and countries across Latin America and elsewhere add further weight to claims about ivermectin’s purported efficacy. In many of the places it has been used, case numbers, hospitalizations and fatalities have tended to fall in relatively short order. Of course, there’s no way of definitively proving that these rapid falloffs are due to the use of ivermectin. Correlation, as we well know, is not causation. But a clear pattern has formed that strongly supports its purported efficacy. And it’s not just regions but entire countries that now appear to be benefiting from its anti-viral and anti-inflammatory properties.
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