Japan has not ditched Covid-19 vaccines for Ivermectin

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Ivermectin Didn’t Save Japan From Covid-19

Why basic critical thinking is quite important when it comes to repurposed medications

Gideon M-K; Health Nerd 2 days ago

In the seemingly endless online discussion about ivermectin, a repurposed anti-parasitic medication that is proposed as a treatment for Covid-19, people have started passionately arguing about Japan. At first, this may seem like something of a non-sequitur, because Japan, like many other nations, has never actually approved ivermectin as a Covid-19 treatment, but the claim has sprung up everywhere recently regardless. Youtubers with millions of followers, anti-vaccine organizations, and strange people on twitter are all agog with the idea that Japan halted their massive Covid-19 wave with nothing but ivermectin:

The basic idea seems simple, and on face value very persuasive — Japan was experiencing a massive wave of Covid-19. Then, on the 13th of August, the Tokyo Medical Association changed everything, getting everyone in Japan on to the miracle drug, and immediately afterwards cases dropped. Therefore, ivermectin saved Japan!

Except, pretty much all of that is very obvious nonsense. The whole story is a bizarre narrative that really shows just how little effort people will take in fact-checking things that support their own favored explanation. In reality, we have no idea if ivermectin was used more in Japan after the 13th of August, and there’s absolutely no reason to believe that the drug did anything at all for Covid-19 in the country.

Let me explain.

Muddling the Media

In August, Japan was facing a serious issue. The Olympics had come to an end, but Covid-19 cases were rising at an alarming rate, and the country was pulling out all the stops to combat the large epidemic. In the face of the highest case rates of the pandemic, Japan implemented emergency provisions over most of the country, the most far-reaching restrictions that the country had ever adopted.

Muddling the Media

In August, Japan was facing a serious issue. The Olympics had come to an end, but Covid-19 cases were rising at an alarming rate, and the country was pulling out all the stops to combat the large epidemic. In the face of the highest case rates of the pandemic, Japan implemented emergency provisions over most of the country, the most far-reaching restrictions that the country had ever adopted.

About two weeks later, cases dropped precipitously, hospitalizations followed, and the wave abruptly ended. Thus, ivermectin works!

Except, there are pretty obvious problems here. The first one is that the Tokyo Medical Association is a local group of doctors — a subsidiary of the Japanese Medical Association, the Japanese equivalent of the AMA — and not actually a government body of any kind. The press conference essentially made the point that ivermectin should be used as a Covid-19 medication, but the doctor speaking had no authority to actually change policy or supply in Japan and there’s no evidence that this did in fact change after he gave his speech — remember, ivermectin was never approved by the government or officially recommended in Japan. Indeed, the official position, followed by most doctors in the country, is that ivermectin should not be used outside of clinical trials, which is not quite the perspective you’d get if you’ve read all these posts online.

Perhaps even more importantly, none of the Japan/ivermectin analyses contain any information on how much ivermectin has been used in Japan for Covid-19 at any time point. How many people were already taking ivermectin in Japan on the 12th of August, and how many started taking it on the 13th? We simply have no idea. The argument is that a single press release by a presumably somewhat important doctor immediately changed the country’s prescribing habits overnight, but there’s no evidence that is true, and it also appears to be contradicted by the government.

So how effective is a single press conference at changing people’s actions? Well, funnily enough, we’ve got a control here — the chair of the Tokyo Medical Association, who promoted ivermectin in August, did the exact same thing in February of 2021. Yes, way back on February 9th, the exact same doctor said the exact same things in a press conference, and shortly afterwards Covid-19 cases started to increase rather than the decrease seen in late August.

Source: OurWorldInData

In other words, if one was to argue that the press release in August somehow had some impact on Covid-19 cases even though we have no idea if it even increased ivermectin use in the country, you would also have to explain how the earlier press conference failed to do the same thing. Why does a non-official doctor promoting ivermectin work one time but do nothing the other?

The reality is pretty simple: it doesn’t. It’s very unlikely that a single press release changed anything at all in Japan, and it’s a ridiculous stretch to argue that because of this single statement the entire country of nearly 130 million people started using the drug. A much more realistic argument is that press releases from the chair of the Tokyo Medical Association have, at best, minimal impact on the use of ivermectin in Japan, never mind the number of Covid-19 cases the country experiences.
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What we really need to run this analysis is an actual, official source that estimates how many people took the drug within defined time periods (days, weeks, months etc), so that we can map that against the number of cases. Ideally you’d get this divided into subnational units, in this case prefectures, so that you could look at ivermectin use compared to case numbers at a fairly granular level.

The point is, none of the people who are promoting the idea that ivermectin saved Japan have put even this most basic level of effort into their work. They have simply compared a single press release by one doctor to a graph of cases/hospitalizations for the country, and concluded absolute nonsense as a result. To do this analysis properly would require some basic levels of diligence and critical thinking, which are anathema to the ivermectin echo chambers online.

So no, ivermectin didn’t save Japan from Covid-19. There’s currently no good way to know how many people in the country even used the drug during their big wave, never mind what relationship (if any) this has had with cases of Covid-19. Ivermectin may be effective against Covid-19 — the jury is still out — but there’s certainly no reason to believe that it did much if anything in Japan.

https://gidmk.medium.com/ivermectin-didnt-save-japan-from-covid-19-afd64641ee4d

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https://www.iflscience.com/health-and-medicine/fact-check-japan-has-not-ditched-covid-vaccines-for-ivermectin/

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