Ivermectin and science

Remember when the President advised the Filipino public to reuse surgical face masks, but only after they soak these in gasoline or diesel if they cannot afford to spray it with alcohol or Lysol? Although patently wrong and even dangerous, the President’s remarks were then explained away by Health Undersecretary and spokesperson Maria Rosario Vergeire as “just a joke.”

President Duterte’s injudicious remarks found a counterpart in former US president Donald Trump’s “advice” to Americans to simply inject disinfectants directly into their bodies to fight COVID-19.

These days, we’re seeing what looks like a replay of the face-masks-soaked-in-gasoline and inject-disinfectants-into-your-body scenarios. But this time, instead of being dismissed out of hand like the previously cited presidential gaffes, what Filipinos are being subjected to is a so-called tentative exploration of a previously debunked “scientific” claim—courtesy of the decision of the Food and Drug Administration (FDA) to issue a “limited permit” for a single hospital (name withheld by the agency) to use ivermectin, the controversial anti-parasitic drug, as treatment for COVID-19.

The drug, developed and used to fight parasitic infections in animals and as a topical formulation for skin ailments in humans, has been the subject of an intense debate waged over mainstream and social media, in the legislature, and within medical circles.

For now, neither the FDA nor the Department of Health has adequately explained the grant of the “compassionate use” permit to the hospital despite the two agencies’ previous position that not enough evidence exists to merit the use of ivermectin in fighting off or curing COVID-19. All FDA Director General Eric Domingo could say was that the drug was an “investigational product” and that there were ongoing clinical trials on its efficacy against COVID-19. Still, without proper authorization, the drug could still not be considered effective or safe, or sold to the public.

This is certainly a surprising turn of events, an abrupt about-face given the FDA’s staunch opposition to the drug’s use as an anti-COVID-19 treatment. In a joint statement issued by a number of medical and health societies along with the FDA-DOH just days ago, the panel’s consensus was that “based on current evidence from randomized control trials, WE DO NOT RECOMMEND the use of Ivermectin for the treatment of COVID-19. It has not been proven to significantly reduce mortality or improve other clinical outcomes. This recommendation will be updated as more evidence is generated from ongoing trials.”

Even Merck, the drug’s manufacturer, has declared that there is “no scientific basis” or “meaningful evidence” to show that ivermectin works against the virus. Also, that there is “a concerning lack of safety data in the majority of studies.”

To be sure, the “compassionate use” permit will be seen and employed by those championing ivermectin as some kind of “proof” of the drug’s efficacy and even safety—even if much of the evidence they offer is personal, anecdotal, coincidental, unscientific, and dubious. If not self-serving. One of the drug’s strongest proponents is a doctor who admitted in a House hearing that he personally “compounded” ivermectin pills from imported pure material and dispensed 25,000 bottles to some 8,000 patients who asked (or paid) for them. Despite this being a patently illegal activity, the doctor has not been arrested or even cited for violating his oath as a doctor.

Meanwhile, Rep. Mike Defensor, ironically representing a party list called Anakalusugan, is openly defying both the health experts’ warnings and the law by pushing through with a campaign to distribute the illegal, unauthorized drug to constituents in Quezon City.

This is proof of how Philippine society—including authorities—ignore and even casually violate laws, rules, and regulations designed to protect the public from charlatans and scofflaws, even if motivated by what they claim to be concern for public welfare.

There are those who believe the entire blow-up over ivermectin is being used to draw people’s attention and ire away from the abject failure of the Duterte administration in its planning, management, and containment of the public health crisis. The public’s discontent at the scarcity of vaccines at this point and the botched COVID-19 response would somehow be eased by plying desperate citizens with the ivermectin placebo.

Journalist Roby Alampay, in a social media post, pleaded with the public not to let ourselves “be used for anybody’s agenda.” Likewise, he begged that Filipinos “not exacerbate the targeting and weakening of institutions, the impact of which will be felt over a much longer term than that even of COVID.”

If this goes on for much longer, Filipinos might as well try soaking their face masks in gasoline or injecting Clorox into their veins.

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