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Covid-19: UK approves Pfizer and BioNTech vaccine with rollout due to start next week

BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4714 (Published 02 December 2020) Cite this as: BMJ 2020;371:m4714

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Re: Covid-19: UK approves Pfizer and BioNTech vaccine with rollout due to start next week

Dear Editor

Ivermectin, an additional tool in COVID-19 management
Wendy E Hoy, Vishal Diwan, Geoffrey A Taylor and Thomas Barody

The December 2nd news of the roll out in the UK of the COVID-19 vaccine developed by Pfizer, BioNTech, was most welcome (1). However, supplemental approaches to COVID-19 containment will still be needed, to cover the contingencies and uncertainties outlined by Doshi (2), and to treat people with the vaccine-breakthrough disease and those who refuse or otherwise do not receive the vaccine.

On Nov 27, a meta-analysis of 28 studies was published by Kory et al (3) describing great benefit of administration of Ivermectin, alone or in combination, at every stage of COVID-19 infection and management, with attendant reductions in transmission, in severity of illness, in hospital admissions and in deaths. On Dec 4 that group released a powerful video summarising these facts (4); they noted too, that the number of quality studies had now increased to 35, all showing benefit of invermectin. This holds promise for reducing spread, mitigating lockdowns, shortening quarantine, saving health care and hospital costs, reducing the burden of "long COVID" syndrome and minimising further business, social and economic disruption created by the virus. Such a therapy might also reduce or prevent “long COVID” syndrome.

Within Australia, with community transmission now well suppressed, we continue to advocate (5,6,7), that Ivermectin-based therapy be evaluated for close contacts of diagnosed COVID-19 cases in future localised outbreaks, such as workplaces, schools, prisons and nursing homes. The recent diagnosis of COVID-19 in a security worker at one of the quarantine hotels in Sydney, NSW, after 25 prior days of no new diagnoses (8), is a case-in-point. An Ivermectin containing regimen could well be evaluated in isolation centres, like the Howard Springs facility outside Darwin, which will soon be able to house more than 1000 incoming international travellers for their obligatory quarantine period. In countries where COVID is not currently contained, this additional intervention could be applied to exposed contacts and be evaluated in a before-and-after treatment fashion by region, or in a controlled approach by alternate locations, suburbs, households etc.

Scenario modelling of likely benefits (clinical, mortal, economic) around a range of estimates of reduction in spread or severity of COVID -19 produced by such Ivermectin regimens might help persuade authorities and governments to evaluate or implement such changes.

References:
1: Emma Reynolds, Stephanie Halasz, Frederik Pleitgen and Lindsay Isaac, CNN; UK becomes first country to authorize Pfizer/BioNTech's Covid-19 vaccine, first shots roll out next week; December 2, 2020. https://edition.cnn.com/2020/12/02/uk/pfizer-coronavirus-vaccine-uk-intl...
2: Peter Doshi: Pfizer and Moderna’s “95% effective” vaccines—let’s be cautious and first see the full data; November 26, 2020. https://blogs.bmj.com/bmj/2020/11/26/peter-doshi-pfizer-and-modernas-95-...
3: Pierre Kory, G. Umberto Meduri, Jose Iglesias, Joseph Varon, Keith Berkowitz, Howard Kornfeld, Eivind Vinjevoll, Scott Mitchell, Fred Wagshul, Paul E. Marik; Review of the Emerging Evidence Demonstratingthe Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19. FLCCC Alliance; Version 6; Nov. 28, 2020.
4: Paul Marik: The I-MASK+ protocol will revolutionize the treatment of COVID-19. The FLCCC
Alliance press conference in Houston, Texas on Friday, December 4, 2020, at 10:30 am (CST);
https://covid19criticalcare.com/
5: Hoy WE, Diwan V. Editorial Rapid Response to Covid-19: A wake-up Call. : Proposed Trials of Ivermectin for post-exposure prophylaxis of COVID-19. BMJ 2020;369:m2021. https://www.bmj.com/content/369/bmj.m2021/rr-2
6: Hoy WE. Editorial Rapid Response to Covid-19: UK government must “get its act together” as modelling suggests 85 000 deaths in second wave, experts say. BMJ 2020; 371:m4242.
https://www.bmj.com/content/371/bmj.m4242/rr-1
7: Taylor, GA. Editorial Rapid Response to Covid-19: What now for Remdesivir? BMJ 2020, 371: m.4457. https://www.bmj.com/content/371/bmj.m4457
8: Kevin Nguyen and Sue Daniel, ABC news. NSW hotel quarantine worker in Sydney tests positive to COVID-19. December 3, 2020. https://www.abc.net.au/news/2020-12-03/sydney-hotel-quarantine-worker-te...

Competing interests: No competing interests

07 December 2020
Wendy E Hoy
Professor/Physician /Nephrologist/Population health researcher, The University of Queensland
Vishal Diwan: Research Coordinator/Manager, Centre for Chronic Disease, Royal Brisbane and Women's Hospital, Brisbane, Queensland, 4029; Geoffrey A. Taylor: Retired Prof and Independent Researcher, Perth, WA, Australia; Thomas Borody: Professor/Founder and Director Centre for Digestive Diseases, Microbiome Therapeutics Institute, Five Dock, NSW
Australia