Ivermectin did not work in Peru

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Desperation, misinformation: how the ivermectin craze spread across the world

With Peru’s health system overwhelmed last year, many residents began self-medicating, an indicator of things to come

Nick Robins-EarlyFri 24 Sep 2021 11.00 BST

Last modified on Sat 25 Sep 2021 01.47 BST

As Covid-19 cases in Peru rose rapidly during the early months of the pandemic, public interest in the drug ivermectin surged.

Misleading information suggesting the drug, used to treat parasites in humans and livestock, had been proven effective against coronavirus reached many Peruvians online, doctors told the Guardian.

With vaccines still in development, desperate physicians soon began administering ivermectin to patients and, despite a lack of evidence of the drug’s effectiveness in treating Covid, Peru’s government included it in treatment guidelines in early May 2020. A frenzy ensued.

“We ran out of ivermectin in all the pharmacies,” recalled Dr Patricia Garcia, the country’s former health minister. “Then there was a black market, and that’s when things got even worse because the veterinary ivermectin use started.”

Like several other Latin American countries, Peru in 2020 experienced a dire Covid emergency that overwhelmed its underfunded healthcare system. Many residents turned to self-medicating with ivermectin, Garcia said. Local politicians and television hosts told audiences to take the drug. SomePeruvians began taking ivermectin that was formulated for livestock and administered through injections, and images of people with necrotic tissue on their skin from shots made their way to Garcia’s desk. Evangelical groups touted ivermectin as equivalent to a vaccine, sending volunteers to inject thousands of people in indigenous communities while referring to the drug as a “salvation”.

Peru’s experience with ivermectin was an early indicator of things to come. Over the past year, the international hype over the drug has led to runs on livestock suppliers, a boom in illegal trafficking and rampant misinformation in several countries.
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In Peru, ivermectin’s use proliferated in the spring and summer of 2020. Rampant misinformation about the drug’s healing powers spread through social media and online messaging platforms, giving people a false sense of what the drug could do.Advertisement

Garcia first saw ivermectin mentioned in relation to Covid in a WhatsApp group in which someone shared an article that falsely claimed the FDA had approved the drug for treating coronavirus.

Similar misinformation about unproven treatments circulated on social media and messaging platforms across Latin American countries. In Bolivia, one Facebook account posted a video claiming ivermectin could “save you from Covid-19” that was shared at least 285,000 times.

Bolivia’s government announced in May 2020 that it would distribute 350,000 doses of ivermectin, even though the country’s health minister, Marcelo Navajas, stated that same month that ivermectin was “a product that does not have scientific validation in the treatment of the coronavirus”.

In Brazil, too, sales of ivermectin exploded,said Dr Silvia Martins, an associate professor of epidemiology at Columbia University. “Early on in Covid people began to look for a miracle medicine,” said Martins.
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By June 2020, health officials and organizations across Latin America started arguing against the use of ivermectin in the fight against Covid. That month, the Pan American Health Organization, an arm of the WHO, advised against using the drug for Covid. Brazil’s National Health Surveillance Agency, which regulates pharmaceuticals, issued a statement in July 2020 stating there was no conclusive evidence that ivermectin worked against coronavirus. Peru’s health ministry removed part of its recommendation for using ivermectin to treat Covid in October 2020, before cutting it altogether this year.

But much of the harm had been done, said Garcia. Ivermectin had given people a false sense of security against the virus, making it difficult for public health officials to later dispel unproven claims about the drug.

Many Peruvians still embrace ivermectin, said Dr César Ugarte-Gil, an epidemiologist at Cayetano Heredia University who ran a clinical trial of ivermectin along with Garcia. “Someone told me a few weeks ago he just got two doses of the vaccine, but he felt safe because he used the ‘correct’ dose of ivermectin,” said Ugarte-Gil.
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Ivermectin goes global

As a second wave of infections hit last October, misinformation about ivermectin began to spread to more and more countries. Many started to see echoes of what happened in Peru and elsewhere in Latin America.

Pro-ivermectin organizations began to promote the drug in several countries, gaining attention with the help of politicians and prominent media figures who questioned the safety of vaccines. Anti-vaccine and anti-lockdown groups latched on, too, claiming a global conspiracy to suppress information about the drug.
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The Malaysian Medical Association, the main representative body for the country’s medical practitioners, warned against the use of ivermectin outside clinical trials in July, after seeing troubling reports of illicit sales and online misinformation. “MMA feels it has a responsibility to the public and the profession to speak out about the ethical and professional dangers involved in promoting unproven treatments without warning of the physical dangers,” Dr Koh Kar Chai, president of the Malaysian Medical Association, told the Guardian.

In recent months, several researchers and analyses have found further issues with the poor quality of studies that examine ivermectin as a treatment for Covid. In July, one medical journal retracted a major pro-ivermectin study from November 2020 after researchers raised concerns over plagiarism and data manipulation, but not before it was widely cited and viewed more than 150,000 times. The authors of a review of 14 existing studies on ivermectin found that evidence did not support using the drug for Covid outside well-designed randomized trials. A rigorous clinical trial at the University of Oxford is also under way to evaluate the efficacy of the drug.
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Garcia and Ugarte-Gil said their research into ivermectin in Peru was hampered because so many potential trial participants had already self-medicated. A potential lesson for future pandemics, Ugarte-Gil says, is that the use of drugs without strong evidence behind them risks making it harder for researchers to evaluate whether such drugs should be administered in the first place.

Garcia argues that far from proving a “miracle cure”, ivermectin use has not stopped countries such as Brazil and Peru from having some of the world’s highest Covid death tolls per capita.

Instead, she says, it’s been baffling to see other countries rushing to embrace ivermectin after Peru’s experience. “I see the same story in the US,” Garcia said. “I think this is crazy.”

https://www.theguardian.com/world/2021/sep/24/ivermectin-covid-peru-misinformation

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