The Drugs Don't Work:Ivermectin As A Cure For Covid?

I feared, and suspected, last night's Skeptics in the Pub - Online talk, Ivermectin for Covid-19:A Tale of Science Gone Wrong with Jack Lawrence, might have been a little dry, a touch too technical for me. I imagined it'd be one for the purists - for a start I'd never even heard of Ivermectin - but, thankfully - as is so often the case with these Skeptics events - I was proved wrong.

First things first. My blog title, The Drugs Don't Work, is a partial untruth. Nobody, least of all Jack Lawrence himself, is saying Ivernectin doesn't work as a drug. It definitely does. It's just not a miracle drug that can cure all ills. Jack works on research for pancreatic cancer treatments and has been looking into Ivermectin's effect on that. He said it's too early to make definitive statements but, so far, it's looking promising.

What Ivermectin definitely works as is as a horse dewormer. Although many people seem to have gotten confused and think it's a horse tranquilizer - which it isn't. But, over the last few years, it's gained a reputation as a safe and effective treatment for Covid. But how has that reputation come about? And is it true?

The US FDA (Food & Drug Administration) clearly don't think so. They sent out a tweet, which went viral, which read, quite simply "You are not a horse. You are not a cow. Seriously, y'all. Stop it".

 

That doesn't seem to tally with the fact that two of the creators of the drug, Satoshi Omura and William C. Campbell, won, in 2015, Nobel Prizes for Medicine. Although that may be because Ivermectin does cure river blindness and is an excellent anti-parasite medication.

Ivermectin's rise has been quite impressive. From being discovered in a sample of soil near a Japanese golf course and narrowly avoiding being called hyvermectin (because that sounds, in some languages, like the word for testicle), it moved into veterinary medicine in the 1970s and then, in the 1980s, started to be used on humans.

It had been proved to reduce viruses in laboratory monkeys and tests on humans were looking promising too. News got out. The numbers of people looking up Ivermectin via Internet search engines rocketed and, in December 2020, Pierre Kory - a critical care physician, told the US Senate that Ivermectin had a "miraculous" effect on Covid. Other scientists, like Dr Andrew Hill in Liverpool, followed up with equally positive noises.

Prescriptions of Ivermectin spiked. Some who were unable to get a prescription turned to unscrupulous right wing 'health care' companies who charged hugely inflated prices for what is a relatively cheap drug. Some of the people involved in selling this drug, a drug that Donald Trump was a big advocate of, were arrested in Washington DC following the Capitol insurrection on January 6th 2021.

Some were not so convinced by Ivermectin. Pointing to the fact that a lot of the trials had been carried out in petri dishes. Sure you can kill off germs in a petri dish but the crucial thing to remember is that a petri dish can't die. You can't kill a petri dish. You can kill a human. So you need to be more careful about what you pump into a human body than what you put in a petri dish.

 

Some of the other positive studies appeared to be very small, some had reporting defects, and some were very low quality. But a large study came out of Egypt. Ahmed Elgazzar, the man behind this study, claimed that Ivermectin led to a 90% reduction in mortality in Covid cases.

Elgazzar was both respected in his field and a prestigious author. Jack Lawrence, at that time, was simply an undergraduate at St George's in Tooting (where my dad ended up after his heart attack in 1997, incidentally). He had no particular interest in Ivermectin but he was assigned to look at Elgazzar's paper and make a critical evaluation of it as part of his course.

After a reasonable period of procrastination, Jack Lawrence got round to it. Pretty soon he observed that some of the English used was very badly written. That's fair enough. Elgazzar's Egyptian and his English is guaranteed to be better than my Arabic. What was more intriguing was that other sections were written in very good English.

Almost as if they'd been cut and pasted from elsewhere. When referring to Covid, Elgazzar would always call it SARS-COV-2. Most people, even in medical circles, don't call it that. Jack Lawrence found the one other example of someone calling it that and, sure enough, the wording in Elgazzar's paper was exactly the same.

Proof that this was a case of plagiarism. Further research found that almost every sentence in Elgazzar's paper had been copied from various other reports, press releases, and even Wikipedia. There is one solitary sentence that Jack Lawrence has so far been unable to prove has been copied but that could change. 

But what of the data? It wasn't easy to find but eventually Jack Lawrence found it hidden behind a password. He had a few attempts at cracking the password and eventually managed it. The password, brilliantly, was simply 1234. 

As soon as he was able to open up the various spreadsheets, one thing became immediately apparent. Patients were listed by their initials. Bad practice and a clear breach of the rules. Even more curiously, the amount of deaths listed didn't add up. One part of the report said four people had died. Another part said nobody had died.

The four deaths were all listed. They were all 51 years old, they all had diarrhoea, they were all diagnosed on 22nd May 2020 and they all died exactly a week later. Their initials were listed as NEM, NME, NES, and NES (again). It started to look very much like they were the same person listed four times.

Other patients who were listed as being part of the trial had actually died before the trial even commenced. Jack Lawrence brought it to the attention of The Guardian who ran a story. The BBC and CNN picked up on it and did the same. Others, however, defended Elgazzar and even accused Jack Lawrence of being against "the great Egyptian revolution".

Without actually specifying which great Egyptian revolution he was against! The one of 2011 or the one of 1952? Nobody, however, asked Jack Lawrence and his team to retract their findings and nobody threatened them with defamation. Dr Andrew Hill went so far as to retract his recommendation of Ivermectin as a Covid treatment and got in touch with Jack Lawrence to offer his support.

This new round of negative publicity didn't have the affect you might think though. Ivermectin prescriptions didn't drop. They spiked again. Ivermectin was now being promoted in "alternative health" spheres. Jack Lawrence didn't say but I think these alternative health spheres are riddled with conspiracy theorists who would believe, quite happily, that Jack Lawrence is some kind of Big Pharma operative out to spread Covid and get rich off the back of it.

Which would be a strange thing to say of a young man who has just criticised a drug that is made by Merck & Co, a huge multinational pharmaceutical company that employs nearly 70,000 people.

So, leaving the tin hat wearers to one side, why do people fake their research? Jack Lawrence believes that it mostly comes from a desire to do good. It comes from people already so convinced that their theory is true they're prepared to cut corners to get the 'research' out there. Sometimes, it comes down to blatant career advancement and, very rarely, it's due to malicious or corrupt intent.

Why people shouldn't fake their research, you'd hope, is a lot clearer. Ivermectin is an effective horse deworming drug and it's very effective in other areas (river blindness) but, as things stand - and science can always change, it has not been proved to be effective in cases of Covid. It is not a miracle drug. 

More genuine study is needed. Both on Ivermectin and on other prospective treatments. Some of which would have been overlooked because of the fake claims made by Ivermectin. That's just one of the consequences of someone liking Elgazzar not doing his job properly. There's also the fact that millions of people have been treated with a drug that might not work and then there's the loss of trust in science. At a time when conspiracy theories are already taking hold faster than I can remember in my life.

To fix these problems, Jack Lawrence said, we need transparency, we need to trust medical experts but still make sure their findings are verified, and we need to check facts and check data whenever we can. We need to think criticially, think skeptically, and then - together - we can change the world. Make it a better place.

Thanks to Jack Lawrence for a really interesting talk, thanks to Clio Bellenis from the Winchester branch of Skeptics for hosting, and thanks, as ever, to Skeptics in the Pub - Online for making these fortnightly Thursday talks (all free by the way) something to look forward to. Mine'a San Miguel with an Ivermectin chaser.