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Seven days in medicine: 30 Dec 2020 to 5 Jan 2021

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.m4974 (Published 07 January 2021) Cite this as: BMJ 2021;372:m4974

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Re: Seven days in medicine: 30 Dec 2020 to 5 Jan 2021

Dear Editor.

A lack of transparency in explaining how evidence and advice are used is certainly operating in the area of pre and post-exposure prophylaxis for COVID-19. With soaring numbers of new cases and of deaths in both the USA and the UK, threatening collapse of health systems and economies, what are the official objections of scientists or policy makers to the application of Ivermectin-based therapies of high risk persons and to close contacts of COVID-19 cases?

Marik, Kory et al (1, 2), Hill (3) and Lawrie (4,5), have summarised the impressive evidence of benefit. With Ivermectin's low cost, easy administration, and broad safety record, even moderately reduced infectivity or disease severity with COVID-19 would be of net benefit. If effective, such approaches would supplement, not replace, standard tracing and isolation procedures and vaccines.

If opposed to such interventions, authorities should specify what additional data they need for a firm recommendation; how many more trials, how many more patients, for how long, and in what settings? Such a dire situation calls for interventions that have decent likelihood, even if not an absolute guarantee, of success; this amounts to a clinical application of the “Precautionary Principle”. Officially endorsed systematic administration of Ivermectin-based prophylactic treatment with guidelines and evaluation, would quickly settle any controversy about effectiveness; it would also allow definition of ideal doses, frequency and route of administration and deliberations about potential drug resistance and its minimisation can follow.

1. Paul Marik: The I-MASK+ protocol will revolutionize the treatment of COVID-19. The FLCCC Alliance press conference in Houston, Texas, Dec 4, 2020 , Front Line COVID-19 Critical Care Alliance.

2. US Senate to the NIH. https://www.hsgac.senate.gov/imo/media/doc/40-317_Comm.%20Homeland%20Sec...

3. Prof Andrew Hill: See Whipple T. Ivermectin: Tests show cheap drug may reduce Covid-19 death toll. The TImes 2021 Jan 4. https://www.thetimes.co.uk/article/ivermectin-tests-show-cheap-drug-may-...

4. Tess Lawrie: Ivermectin reduces the risk of death from COVID-19 – a rapid review and meta-analysis in support of the recommendation of the Front Line COVID-19 Critical Care Alliance. 3 January 2021. Evidence-based Medicine Consultancy Ltd. Bath.

5. Tess Lawrie to Boris Johnson. A letter to Mr. Boris Johnson from UK scientist Dr. Tess Lawrie calling on him to start saving lives with Ivermectin. Health Rising 2021. Forums. Health News

Competing interests: No competing interests

11 January 2021
Wendy E Hoy
Physician and Researcher
None
University of Queensland
Centre for Chronic Disease, Royal Brisbane and Women's Hospital, Herston