[FALSE] Can ivermectin be used to treat COVID-19?

Screenshot of the Weibo post

The Claim and Our Verdict

• The claim: A video shared Oct. 10, 2021, on Weibo, claims that ivermectin, a very effective treatment for COVID-19, has been discovered in India.
• Fact-checking:
  • According to the World Health Organization (WHO), ivermectin is an anti-parasitic drug. Although a study proves ivermectin effective in inhibiting coronavirus in in vitro experiments (laboratory-controlled environment), the drug’s effectiveness against COVID-19 inside human body has not been proven. Another study’s findings do not support the drug’s effectiveness against COVID-19. The drug was also not discovered in India. An article published by the WHO claims that the current evidence on the use of ivermectin to treat COVID-19 patients is inconclusive.
  • Dr. Hung Ivan Fan-Ngai, clinical professor in the Department of Medicine at The University of Hong Kong and a member of the Hong Kong advisory panel on COVID-19 vaccines, responded to our inquiry and said that majority of the large randomized controlled trial did not show any clinical benefit and hence, did not support the use of ivermectin for both prevention and treatment for COVID-19.
  • Hong Kong’s Drug Office forwarded two safety alerts published by European Medicines Agency and Australia’s Therapeutic Goods Administration, both of which said the available data do not support the use of ivermectin against COVID-19. As of the issuance of this report, Hong Kong health authority did not approve or recommend ivermectin to treat COVID-19, nor did the U.S. Food and Drug Administration (FDA).
  • Based on the available information and data, ivermectin has not alleviated the pandemic in Brazil, Peru and India.
• Our ruling: Therefore, we rate the claim as FALSE.

News Brief

A video, submitted by the public for fact check, claims that a very effective treatment for COVID-19 has been discovered in India. The narration translates as, “It is called ivermectin. It was used to treat conditions caused by parasitic worms. In the laboratory, it was found to be effective in killing coronavirus. The drug has been proved effective and drastically reduced infections in countries such as Brazil and Peru. In India, the states where ivermectin was used to treat COVID-19, the pandemic had been reduced by 90%. Three most renowned scientists in America said they were hoping to end the pandemic with this drug.”

The video was shared in a Weibo post published Oct. 10, 2021. As of the issuance of this report, the video has been viewed tens of thousands of times. The post had been shared 37 times and had received 50 comments and 145 likes.

Fact-checking

Has ivermectin been proven to be effective against COVID-19?

According to the International Pharmacopoeia (10th edition) compiled by the World Health Organization (WHO), ivermectin is an anti-parasitic drug.

The drug was discovered in 1970s by a Japanese scientist Satoshi Omura and an Irish biologist William C. Campbell, who was affiliated with Merck, Sharp and Dome (MSD) research laboratories in the United States. It was not discovered in India, as purported in the claim.

A literature review discovered that the claim that ivermectin was effective in killing coronavirus originates from an article published in June 2020 in the journal of Antiviral Research, titled “The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro.” The article claims that ivermectin is an inhibitor of the COVID-19 causative virus (SARS-CoV-2) in vitro and a single treatment is able to affect about 5000-fold reduction in virus at 48-hour in cell culture. However, the research findings are only based on in vitro experiments—experiments conducted in laboratory-controlled environments. The drug’s capability of inactivating the coronavirus inside human body has not yet been proven.

Another article was published in April 2021 in the Journal of the American Medical Association (JAMA), titled “Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19: A Randomized Clinical Trial.” The study conducted a double-blind and randomized trial involving adult COVID-19 patients. The result shows that among adults with mild COVID-19, a 5-day course of ivermectin, compared with placebo, did not significantly improve the time to resolution of symptoms. The findings do not support the use of ivermectin for treatment of mild COVID-19, although larger trials may be needed to understand the effects of ivermectin on other clinically relevant outcomes.

A screenshot of the article published in JAMA

An article published March 31, 2021 by the WHO claims that the current evidence on the use of ivermectin to treat COVID-19 patients is inconclusive. Until more data is available, WHO recommends that the drug only be used within clinical trials. This recommendation, which applies to patients with COVID-19 of any disease severity, is now part of WHO’s guidelines on COVID-19 treatments.

In summary, ivermectin was neither discovered in India, nor found by Indian researchers; its efficacy against COVID-19 is still controversial. Based on the available information, the drug’s effect in inhibiting coronavirus inside human body has not yet been proven, while another clinical trial does not support its use as a treatment for COVID-19. In absence of the above information, the claim will mislead the public to believe that ivermectin has been proven to be effective as a treatment for COVID-19.

Dr. Hung Ivan Fan-Ngai, clinical professor in the Department of Medicine at The University of Hong Kong and a member of the Hong Kong advisory panel on COVID-19 vaccines, responded to our inquiry and said, “Majority of the large randomized controlled trial (including a 400 patients trial published in the JAMA) did not show any clinical benefit and hence, did not support the use of ivermectin for both prevention or treatment.”

A keyword search found two safety alerts on the use of ivermectin published by Drug Office, Department of Health, Hong Kong (HKDO). The first one was published March 23, 2021, titled “European Union: EMA advises against use of ivermectin for the prevention or treatment of COVID-19 outside randomised clinical trials.” Another one was published Sept. 11, 2021, titled “Australia: New restrictions on prescribing Ivermectin for COVID-19.” The March 23 alert quoted European Medicines Agency (EMA)’s announcement and says, “It (EMA) has reviewed the latest evidence on the use of ivermectin for the prevention and treatment of COVID-19 and concluded that the available data did not support its use for COVID-19 outside well-designed clinical trials.” The Sept. 11 alert says, “The (Australia’s)Therapeutic Goods Administration (TGA), acting on the advice of the Advisory Committee for Medicines Scheduling, has placed new restrictions on the prescribing of oral ivermectin. General practitioners are now only able to prescribe ivermectin for TGA-approved conditions (indications) – scabies and certain parasitic infections.” It adds, “…its (ivermectin’s) use by the general public for COVID-19 is currently strongly discouraged by the (Australia’s) National COVID Clinical Evidence Taskforce, the World Health Organization and the U.S. Food and Drug Administration.”

Has the use of ivermectin alleviated the pandemic in Brazil, Peru and India?

According to the Associated Press and several other media reports, President Jair Bolsonaro of Brazil promoted a series of anti-pandemic measures, including the “Early Treatment of COVID-19.” The use of ivermectin is part of the treatment. However, its effectiveness against COVID-19 has been in doubt and the pandemic in Brazil has not been controlled after the implementation of the treatment.

According to the data released by Worldometer, a reference website that provides counters and real-times statistics for diverse topics including COVID-19, there has been no significant improvement in the pandemic in Brazil since March 2020.

Daily new cases in Brazil, published by Worldometer.

An announcement published July 10, 2020 (updated April 30, 2021) by Brazilian Health Regulatory Agency (Agência Nacional de Vigilância Sanitária, Anvisa) says that ivermectin currently has not been approved to prevent or treat COVID-19 in Brazil.

News articles published by the Brazilian local media organization Congresso em Foco and CNN Brazil claim Brazilian health authorities admitted the ivermectin, as part of the “Early Treatment of COVID-19”, has been proven to be ineffective in containing coronavirus, and has called for investigation into the advocates of the drug.

A commentary article published Oct. 5, 2021 on the website of The Lancet claims that the so-called “Early Treatment for COVID-19” with the “COVID Kit” drugs, including ivermectin, promoted and prescribed in Brazil, is unscientific, distracting and potentially harmful. “For the time being, the Brazilian Federal Board of Medicine should officially prohibit the ‘Early Treatment of COVID-19’ in Brazil with the ‘COVID Kit’ drugs,” according to the article.

In the early stage of the pandemic in Peru, the government approved ivermectin to be used as a treatment for COVID-19. Nonetheless, according to Agence France-Presse (AFP) and Andina, Peru’s state news agency, Peru’s Minister of Health Óscar Ugarte announced March 27, 2021 that Peru will stop using ivermectin to treat COVID-19 due to the lack of evidence to support its benefits. Data from Worldometer also shows that the pandemic in Peru has not exacerbated since March 2021, i.e., the official halt of the use of ivermectin against COVID-19.

Daily new cases in Peru, published by Worldometer.

The “Clinical Guidance for Management of Adult COVID-19 Patients” published May 17, 2021 by the Indian Council of Medical Research (ICMR) recommended ivermectin for treating COVID-19 of mild disease in India. However, according to the statistics from Worldometer, the daily new cases of COVID-19 started to decrease before the issuance of the guidance.

The guidance updated Sept. 23, 2021 no longer included ivermectin as the recommended treatment for COVID-19. Based on the available evidence, the decrease in daily infections in India was not associated with the use of ivermectin.

Daily new cases in India, published by Worldometer.

The Weibo video also claims that three most renowned scientists in America says they are hoping to end the pandemic with this drug. Keywords search found a news article published June 12, 2021 by ETtoday, an online news website in Taiwan. This news article cited a study published in the American Journal of Therapeutics as the evidence.

However, this journal article was rejected by Frontiers in Pharmacology. A statement published March 2, 2021, on the website of the journal, states, “Upon further scrutiny by our Research Integrity team about the objectivity of this paper during the provisional acceptance phase, it was revealed that the article made a series of strong, unsupported claims based on studies with insufficient statistical significance, and at times, without the use of control groups. Further, the authors promoted their own specific ivermectin-based treatment which is inappropriate for a review article and against our editorial policies… In our view, this paper does not offer an objective nor balanced scientific contribution to the evaluation of ivermectin as a potential treatment for COVID-19.”

An article published Sept. 3, 2021 by FDA claims that it has not authorized or approved ivermectin for use in preventing or treating COVID-19 in humans or animals, and currently available data does not show ivermectin is effective against COVID-19. The article adds that use of animal ivermectin for the prevention or treatment of COVID-19 in humans is dangerous. As of the issuance of this report, the FDA had not approved ivermectin as a treatment for COVID-19.