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Michael Hiltzik: The most striking side effect of ivermectin appears to be stupidity

Michael Hiltzik: The most striking side effect of ivermectin appears to be stupidity

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In this world in which self-interested mountebanks command followers on social media and the airwaves by the millions, it doesn’t take much for a misinformation and disinformation campaign to cloud people’s minds.

Today, let’s talk about ivermectin.

As we reported recently, the generic medicine, most commonly used as a dewormer for farm animals and household pets, has been taken up as a cause by a right-wing claque of anti-government and anti-vaccine activists.

Their claim is that ivermectin is some sort of miracle drug that can save the lives of COVID-19 patients even if they’re at death’s door.

Its leading promoters include conspiracy theorists and physicians whose water-carrying for earlier anti-COVID-19 nostrums such as the anti-malarial hydroxychloroquine marked them as sources of dangerous misinformation.

As with those treatments, there is no scientifically valid evidence that ivermectin works on COVID-19 or the coronavirus that causes the disease. The evidence indicates, as a large recently published study of COVID-19 treatments found, that in those cases it has “no effect whatsoever.”

Yet the ivermectin craze has only intensified, alarming medical authorities. The Mississippi Department of Health felt compelled last week to issue a special alert to doctors and hospitals about a spike in calls to its poison control center, warning that “at least 70% of the recent calls have been related to ingestion of livestock or animal formulations of ivermectin purchased at livestock supply centers.” At least one user was hospitalized.

The agency asked medical providers to advise patients about something that one would have thought would be obvious: “To not take any medications intended to treat animals.”

The federal Centers for Disease Control and Prevention issued its own emergency warning. Calls to poison control centers reporting adverse effects from ivermectin increased fivefold in July over a year earlier, the CDC said.

That was consonant with a 24-fold increase in prescriptions at retail pharmacies, to 88,000 in the week ending Aug. 13 from an average of 3,600 per week in the pre-pandemic period through February 2020.

The only possible explanation for the surge in prescriptions is the drug’s misuse as a COVID-19 treatment or preventive, as its promoters claim.

The Food and Drug Administration approves the drug for treatment of two conditions caused by parasitic worms and occurring chiefly in tropical habitats — intestinal strongyloidiasis and onchocerciasis — as well as head lice and skin conditions such as rosacea, for which topical applications are approved. The drug is most commonly used at veterinary strength to control parasitic worms in livestock.

Overdoses can result in nausea, vomiting and diarrhea, the CDC warned. That’s at the mild end. More seriously, the CDC said, “overdoses are associated with hypotension and neurologic effects such as decreased consciousness, confusion, hallucinations, seizures, coma and death.”

The CDC’s figures don’t include veterinary prescriptions, but the agency said those were a particular problem. “Veterinary formulations intended for use in large animals such as horses, sheep and cattle ... can be highly concentrated and result in overdoses when used by humans,” the CDC warned. “Animal products may also contain inactive ingredients that have not been evaluated for use in humans.”

The Food and Drug Administration backed up its own alert on ivermectin with a tweet advising: “You are not a horse. You are not a cow. Seriously, y’all. Stop it.”

These warnings overlook what may be the most dangerous side effect of the popular fascination with ivermectin: stupidity. The conspiracy mongering about the drug has become increasingly febrile. Sen. Rand Paul, R-Ky., this week blamed “hatred for Trump” for what he asserted was an unwillingness among scientists to study ivermectin, as well as other purported anti-COVID-19 nostrums.

“They will not study ivermectin,” Paul told a constituents gathering this week. “They will not study hydroxychloroquine without the taint of their hatred for Donald Trump.”

In fact, both drugs have been studied for their potential effect on COVID-19; both have been found ineffective.

Despite the negative results on ivermectin, however, research continues. It is one of several drugs approved for other diseases to be tested for their effect on COVID-19 in a nationwide trial headed by Duke University researchers. The Duke trial was funded by the American Rescue Plan, the $1.9 trillion stimulus bill enacted in March. Paul voted against the bill. Another ivermectin study is being undertaken at the University of Minnesota.

In an Aug. 23 tweet, another ivermectin promoter, Los Angeles child psychiatrist Mark McDonald, attacked as “ignoramuses” those who questioned ivermectin as a COVID-19 treatment because of its applications for livestock. McDonald has been a vocal critic of COVID-19 vaccination, and in a conference convened this month by Florida Republican Gov. Ron DeSantis to discuss masking rules for K-12 pupils, he stated, “Masking children is child abuse.”

If, in fact, studies of ivermectin are ongoing, what’s the problem with pushing it now? The answer is that its proponents talk as though the evidence is complete and is conclusively pro-ivermectin. That’s especially dangerous because it’s often offered as an alternative to vaccination, which is the one therapeutic known conclusively to fight the COVID-19-causing coronavirus and moderate the severity of the disease.

To support their campaign, the proponents point to studies that supposedly document ivermectin’s ability to reduce hospital stays and promote the recovery of COVID-19 patients.

Many of those studies have been criticized as scientifically untrustworthy — “pseudoscience,” in the words of Australian epidemiologist Gideon Meyerowitz-Katz, whose examination of a highly touted meta-analysis of ivermectin studies found it riddled with faulty statistical calculations, erroneous math, invalid conclusions and obvious cherry-picking to portray results as more positive than was warranted.

Nevertheless, the promotion of ivermectin has even prompted judges to demand that doctors give patients the drug. An Ohio state judge last week ordered a Cincinnati hospital to treat a patient with severe disease with ivermectin for three weeks. Since the hospital’s staff physicians refused to comply, the hospital had to find an outside doctor to perform the treatment.

The judge was acting on a lawsuit brought by the patient’s wife, who cited claims by Fred Wagshul — an Ohio doctor who co-founded an ivermectin promotion group and told the Ohio Capital Journal that the evidence favoring ivermectin in COVID-19 cases was “irrefutable” — that the CDC and FDA were engaged in a “conspiracy” against ivermectin, and that national and social media were guilty of “censorship” of positive information about the drug.

Nor was the Ohio judge the first: Judges in New York and Chicago have issued similar orders. This may be the longest-lasting consequence of the promotion of scientific misinformation in the pandemic. Scientific authority has become conditional, and more ignorance, illness and death may be the inevitable result.

Michael Hiltzik is a columnist for The Los Angeles Times.

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