Ivermectin is the New Hydroxychloroquine

Another drug that won't cure COVID goes viral. And why social media companies will only do so much to halt misinformation about it.

Ivermectin is an anti-parasitic drug that was introduced to the market in 1981. Forty years later, it is having a resurgence as a potential COVID-19 cure, despite a lack of credible evidence of its effectiveness. In 2020, there was a similar rise in interest and use in two anti-parasitic drugs that also lacked effectiveness in treating COVID: hydroxychloroquine and chloroquine. These drugs have been promoted by many of the same people who peddle COVID vaccine misinformation. Here are five aspects in both of the drugs gaining popularity.

  1. Big Megaphones Promote the Cure, Despite a Lack of Credible Evidence

President Donald Trump was a superspreader of coronavirus misinformation. He embraced hydroxychloroquine in March 2020, despite the fact that evidence about it was anecdotal. At a press conference on March 21, 2020, he said he was a "big fan" of the drug, while White House Coronavirus Task Force adviser Dr. Anthony Fauci said the evidence was "anecdotal" and "the answer is no" when asked whether it was a treatment for coronavirus. The next day, Trump tweeted the success of a small French study of the drug, coupled with the antibiotic azithromycin. The study was disavowed by its publisher two weeks later because it did not meet the journal's standards. (Trump did not tweet the statement on the paper.)

By 2021, Trump had been banned from social media. But ivermectin found other advocates with big platforms on social media and cable news. Fox News host Laura Ingraham said in February that the drug was "good to take." She also said that the drug and hydroxychloroquine -- which by that time had been fully discredited -- provided "enormous benefit." Other Fox personalities, like Tucker Carlson, had guests who promoted the drug. Podcaster Joe Rogan had an episode on June 22 featuring boosters of the drug. He recently came down with COVID and said he took it -- but only along with established treatments such as monoclonal antibodies and prednisone. (He didn't say whether he had been vaccinated.) Some of the most cited studies of the drug as a COVID cure or prophylaxis have been either withdrawn or have been conducted by doctors who did not disclose that they were part of an ivermectin advocacy group.

  1. Videos full of Misinformation Rack Up Millions of Views on Social Media

A viral video in July 2020 by a group calling themselves "America's Frontline Doctors" touted hydroxychloroquine and azithromycin as a cure for COVID, while saying that masks weren't necessary. Trump and Donald Trump Jr. retweeted videos of the doctors. The video -- and variations of it -- garnered millions of views on Facebook and YouTube before ultimately being taken down.

In 2021, a similar thing happened with ivermectin. An anti-mask, anti-vaccine, pro-ivermectin video featuring a doctor named Dan Stock speaking at an Ohio school board meeting got at least 30 million views on social media platforms such as Facebook, YouTube, and TikTok in August, according to Media Matters for America. Right-wing figures like Rep. Jim Jordan (R-Ohio), former Trump official Sebastian Gorka, and pundit Candace Owens promoted the video. While social media companies did take some of the videos down, I was able to find a copy of the video easily on YouTube, despite the company's policy of saying it prohibits content “about COVID-19 that poses a serious risk of egregious harm” or “contradicts local health authorities’ or the World Health Organization’s (WHO) medical information about COVID-19.” 

  1. Search Engine Interest Skyrockets

Google searches for both drugs shot up after the viral videos spread on social media. Hydroxychloroquine reached its peak in July 2020, around when Trump and Trump Jr. were promoting the videos. Ivermectin is at a high right now:

Google search interest for ivermectin is highest in states with low vaccination rates:

Prescriptions -- or Attempts to Get the Drug by Other Means -- Surge 

Prescriptions for hydroxychloroquine and chloroquine surged after Trump mentioned the drugs in March 2020. According to the New York Times, first-time prescriptions of the drugs were up 46 times the normal average to 32,000 on a single day in March 2020, prescribed by a range of doctors who are not infectious disease specialists, including psychiatrists, podiatrists, dermatologists, and cardiologists.

Ivermectin prescriptions have jumped to 88,000 per week, up from an average of 3,600 per week, according to the New York Times. And for those who cannot get a doctor to prescribe for them, some people have been buying a potent form of the drug meant for horses and cattle found at feed supply stores. Taking a drug meant for animals is extremely dangerous, both because of its potency and because it may include inactive ingredients that aren't tested for human consumption. This danger hasn't stopped it from flying off the shelves, while other stores stopped selling it.

  1. People Get Sick -- And Even Die -- While Trying to Take Variations of the Drug

Misinformation about the drugs has consequences that can be deadly. An Arizona man died, and his wife was hospitalized, after taking chloroquine phosphate, an additive to clean aquariums, after Trump touted the drug. The F.D.A. warned against using hydroxychloroquine or chloroquine in hospital settings or clinical trials in July 2020 for COVID-19 after the drug posed severe risks, including heart arrythmias. (The F.D.A. said the drugs were still safe for approved uses to treat malaria, lupus, and rheumatoid arthritis.)

Poison control centers have seen a sharp uptick in calls about ivermectin in recent weeks. According to the American Association of Poison Control Centers, centers fielded 459 calls about ivermectin in just the month of August, up from 133 in July, and eclipsing all of the total calls about ivermectin in 2019, which numbered 402. The C.D.C. reported the following cases from poison control centers:

An adult drank an injectable ivermectin formulation intended for use in cattle in an attempt to prevent COVID-19 infection. This patient presented to a hospital with confusion, drowsiness,  visual hallucinations, tachypnea, and tremors. The patient recovered after being hospitalized for nine days.

An adult patient presented with altered mental status after taking ivermectin tablets of unknown strength purchased on the internet. The patient reportedly took five tablets a day for five days to treat COVID-19. The patient was disoriented and had difficulty answering questions and following commands. Symptoms improved with discontinuation of ivermectin after hospital admission.

In addition to the medical consequences of taking drugs without the direction of a physician, ivermectin may give vaccine-hesitant individuals another reason to avoid getting the shot. In their eyes, ivermectin is a safer alternative than vaccination and it is being promoted as both a prophylaxis and a cure. The drug also may give people a false sense of security, and thus they might choose to not take other proven interventions like vaccines, masks, and social distancing.

The surge in interest is also happening after Trump, who flagrantly spread coronavirus misinformation, was deplatformed, and all social media platforms have comprehensive policies to delete coronavirus misinformation. Those policies haven't stopped videos full of health misinformation from racking up millions of views before often -- but not always -- being taken down. Inevitably, when these videos are taken down, their critics charge that they are being censored. That puts platforms in the position of being a referee, which they'd rather not be. Hence Facebook's ubiquitous ad campaign supporting "updated Internet regulations'' -- the company would rather have these types of content moderation decisions be regulated by Congress, which appears unlikely to be in the offing. Until that happens, misinformation will never fully vanish from these platforms because the companies are going to try to placate both the left and the right.

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