Scientists mystified, wary, as Africa avoids COVID disaster

While I agree ivermectin is a wonderful multi-use drug and would even class it as a Wonder Drug, I am not convinced it is all that helpful when it comes to Covid. I understand why it should theoretically be of at least some use in the earliest stages, and concede it may be beneficial in some cases if taken early enough, but I don’t think it is the panacea so many here seem to believe it is.

In the beginning, I really hoped it would be helpful, but my hopes faded as more and more evidence emerged that it is only marginally and sporadically beneficial at best. We now have access to monoclonal antibodies, which really do work. MAB rock! I can understand why some health care agencies might prohibit their staff from prescribing ivermectin for Covid patients. Despite the many studies done by now (and many still ongoing) worldwide, there is no evidence, based on proper studies, that it does much of anything. Given how lawsuit-happy we are in this country, they are probably afraid of malpractice suits and can’t blame them for that.

It does seem there should be some mechanism to allow patients who want to take it for Covid to do so, perhaps by signing a waiver that they understand it is not a proven cure or preventative but want it anyway. The trouble with that is, though, would it really stand up in court and would there be additional hospitalizations for patients trying ivermectin instead of getting MAB, and then when it does not work they are beyond the time frame for effective administration of MAB and end up in the ICU (we have to look at the big picture as well as the individual case, especially during a pandemic).

As it stands now, we have MAB (proven highly effective in early stages) and those who really want ivermectin instead can fork over their $ to Frontline Doctors and get it, or go to Tractor Supply and get horse paste or take doggie heartworm pills or whatever.

I really, really wish ivermectin were a Covid wonder drug, as it’s cheap, safe and widely available. Sadly, it appears to me it is not.

Perhaps we will find something cheap and safe and easily available that works for Covid. I certainly hope and pray so! Lots of studies and trials are ongoing as I type (including involving my old friend artimisinin). Perhaps a therapy that is proven to work will include something like ivermectin or HCQ, who knows?

There have been quite a number studies in many countries that have shown ivermectin as having only marginal effect on Covid at best. I don’t think all of these researchers in all of these countries have been corrupted by Big Pharma. Some here on FR may believe so, and there is no convincing them otherwise (a number of these people are also Q followers or believe Ashli Babbitt was a “crisis actor” and is still alive, the blood was fake, etc). Ivertmectin is practically a religious sacrament to some of them, and they will defend it with spittle flying. There are also more reasonable people here who still believe in ivermectin for Covid. Maybe they are right. I have very serious doubts.

As for Africa, I don’t think ivermectin has much, if anything, to do with the much lower Covid rates. First, while it is still used to prevent river blindness (some Freepers have made a big do of this) in high-risk villages where elimination has not yet been reached, as of 2015:

“In phase 1A 127 665 people from 639 villages in 54 areas were examined. The prevalence had fallen dramatically. The decline in prevalence was faster than predicted in 23 areas, on track in another 23 and delayed in eight areas. In phase 1B 108 636 people in 392 villages were examined in 22 areas of which 13 met the epidemiological criteria for stopping treatment. Overall, 32 areas (25.4 million people) had reached or were close to elimination, 18 areas (17.4 million) were on track but required more years treatment, and in eight areas (10.4 million) progress was unsatisfactory.”
source: https://pubmed.ncbi.nlm.nih.gov/27349645/

Since 2015, many of the remaining areas have been declared free of river blindness and ivermectin has been discontinued. Let’s be super generous and say 30 million people are still on ivermectin (although it is likely far fewer). Out of a total population of 1.1 billion, that’s slightly less than 3%. Even if you double or quadruple the number, still not enough to make an impact on overall Covid rate.

It is also used to treat the lymphatic form of filariasis, elephantitis. In 2018, 212.7 million were treated with MDA (mass drug administration) with albendazole in combination with either ivermectin or diethylcarbamazine (the latter combination in countries non-co-endemic for onchocerciasis) or albendazole alone were implemented progressively in endemic counties.

“Two countries, Togo and Malawi, from the WHO AFRO eliminated LF as a public health problem in 2017 and 2020, respectively. In 2019, Cameroon discontinued MDA programmes and transitioned to post-elimination surveillance. Several countries (Benin, Burkina Faso, Ethiopia, Ghana, Madagascar, Mali, Nigeria, Senegal, Uganda and the United Republic of Tanzania) have stopped MDA in at least one EU.”
Source: https://academic.oup.com/inthealth/article/13/Supplement_1/S22/6043665

To see the maps, go here and click on regional maps, choose Africa continent, then click on the little eyeball next to MDA/PC delivery 2020 to see where there was MDA in 2020 (dark purple areas):
https://espen.afro.who.int/diseases/lymphatic-filariasis

Just as an example, because Mozambique is nearly all purple while neighboring Tanzania is purple-free, let’s look at Covid rates in those countries. Cumulative cases per million in Mozambique are much higher (5,000) than in Tanzania (500). The opposite of what one would expect if ivermectin worked. Or how about Guinea, nearly all purple, with around 2,300 cases per million (cumulative) vs about 1,200 in neighbouring purple-free Liberia. Again the opposite of what one would expect if ivermectin worked.

Yes, ivermectin is used to treat other fairly common maladies in Africa, intestinal round worms, for example (for round worm infestations of the lung in little kids — at a certain stage they can cause some pretty nasty respiratory distress in the tiny ones — I used this stuff labelled “vermifuge” with albendazole as the active ingredient), plus other icky worms like hook worms. It’s also used to treat scabies sometimes, but usually something topical and cheap is used, like dousing with a trusty jug of permectrin (also good for lice). For roundworms, it’s a one time dose. Seeing as how we were so generous with ivermectin for river blindness and elephantiasis, I think we can skip thinking any of this this makes any difference in Covid rates.

So, in 2018, about 213 million were included in MDA for elephantiasis. We don’t know exactly how many received albendazole+ivermectin vs albendazole+diethylcarbamazine vs the triple regimen. We know that by 2020 a number of regions stopped MDA and switched to surveillance. But we don’t don’t know exactly how many people discontinued the medicine. Let’s be super nice to the ivermectin brigade, and say a total of 213 million Africans were taking ivermectin during Covid, even though we could well assume it was fewer. That is still only about 20% of the total population. And, given that the Covid rates are not consistently lower in MDA vs non-MDA areas, at least as far as we can see from the data right now, and are in at least some cases much higher, I don’t see evidence that ivermectin is what is making the difference.

We do know that age and obesity play a large role in Covid severity and mortality. We also know that diabetic patients have worse outcomes. And we know that sub-Saharan Africa has drastically lower rates of obesity and diabetes and a much lower median age than parts of the world much harder hit by Covid. In addition, we know people with adequate levels of vitamin D tend to fare better, and that the virus does not survive very well in sunlight. We also see Covid rates spike in developed countries when it is quite cold or hot and people stay indoors in climate-controlled buildings. And we certainly know Covid ravages nursing homes. So it stands to reason that the following have more to do with lower Covid rates in sub-Saharan Africa:

Lower rate of obesity
Lower rate of diabetes
Lower median age
More sunlight and fresh air
They don’t do nursing homes
Less time spent in climate-controlled buildings
More robust immune systems due to higher disease burden

If a study is done comparing Covid rates in villages where residents are taking ivermectin versus similar villages where they are not, and it turns out the ivermectin villages fared significantly better, that might change my mind. In the meantime, I am glad we have MAB.

I will follow up with a post of maps. Anyway, the good news is that great strides have been made since 2011 on the elephantiasis front, with only about 120 million now affected and about four times that at risk. Still too many, of course, but getting better all the time and way better than 2011.

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