Which widely available drug will end up being being touted as the next COVID miracle cure among anti-vaxxers now that hydroxychloroquine and ivermectin have fallen by the wayside?

Viagra, maybe? Lots of senior citizens already have that in their medicine cabinet. It’d be ironic watching people refuse Pfizer’s new COVID antiviral, Paxlovid, because they don’t trust pharmaceutical companies only to turn around and pop an even more famous drug made by Pfizer instead.

This new study comes from Malaysia and was conducted between May and October of last year, when Alpha and Delta were prevalent. Researchers wanted to see how people aged 50 years or older who’d already been hospitalized for COVID would fare with — and without — ivermectin. Half the sample got that drug plus the usual standard of care during the first seven days after symptoms began while the other half got the standard of care alone. Would the ivermectin group see meaningfully better outcomes than the control group?

No, it turns out. Not only didn’t they have better outcomes, the researchers warned doctors to be careful about prescribing a drug like ivermectin that caused as many side effects as they saw.

Among the 490 patients, 95 (19.4%) progressed to severe disease during the study period; 52 of 241 (21.6%) received ivermectin plus standard of care, and 43 of 249 (17.3%) received standard of care alone (RR, 1.25; 95% CI, 0.87-1.80; P = .25)…

There were no significant differences between ivermectin and control groups for all the prespecified secondary outcomes (Table 2). Among patients who progressed to severe disease, the time from study enrollment to the onset of deterioration was similar across ivermectin and control groups (mean [SD], 3.2 [2.4] days vs 2.9 [1.8] days; mean difference, 0.3; 95% CI, −0.6 to 1.2; P = .51). Mechanical ventilation occurred in 4 patients (1.7%) in the ivermectin group vs 10 (4.0%) in the control group (RR, 0.41; 95% CI, 0.13 to 1.30; P = .17) and intensive care unit admission in 6 (2.5%) vs 8 (3.2%) (RR, 0.78; 95% CI, 0.27 to 2.20; P = .79). The 28-day in-hospital mortality rate was similar for the ivermectin and control groups (3 [1.2%] vs 10 [4.0%]; RR, 0.31; 95% CI, 0.09 to 1.11; P = .09), as was the length of hospital stay after enrollment (mean [SD], 7.7 [4.4] days vs 7.3 [4.3] days; mean difference, 0.4; 95% CI, −0.4 to 1.3; P = .38).

By day 5 of enrollment, the proportion of patients who achieved complete symptom resolution was comparable between both groups (RR, 0.97; 95% CI, 0.82-1.15; P = .72).

That finding wasn’t unusual, the researchers noted: “In 2021, 2 randomized clinical trials from Colombia and Argentina found no significant effect of ivermectin on symptom resolution and hospitalization rates for patients with COVID-19. A Cochrane meta-analysis also found insufficient evidence to support the use of ivermectin for the treatment or prevention of COVID-19.” Other studies that appear to show COVID patients doing better after taking ivermectin may have been distorted by the fact that they were conducted in regions prone to intestinal parasites. Ivermectin was designed as an anti-parasitic medication; someone who has COVID and a parasitic infestation who takes ivermectin may find themselves suddenly cured of the latter problem, allowing their body to produce a more robust natural immune response to SARS-CoV-2. There may be a correlation between ivermectin and COVID recovery in those regions, in other words, but not causation.

Of note: “A total of 55 AEs [adverse events] occurred in 44 patients (9.0%) (Table 4). Among them, 33 were from the ivermectin group, with diarrhea being the most common AE (14 [5.8%]).” That is, three times as many members of the ivermectin group experienced side effects as the control group. “The notably higher incidence of AEs in the ivermectin group raises concerns about the use of this drug outside of trial settings and without medical supervision,” the researchers concluded.

Nothing wrong with popping a little ivermectin if you don’t mind diarrhea and if you’ve already been vaccinated. But if you’re taking ivermectin instead of getting vaccinated, as appears to often be the case in red counties, bad things can happen. And have happened:

That’s from a David Leonhardt piece this morning pointing out how COVID deaths in red and blue counties were comparable right up until all U.S. adults became eligible for vaccination, at which point dying from the disease increasingly became a Republican phenomenon. Even this year, with Omicron blitzing Democratic strongholds like New York City, red counties continue to see more deaths than blue ones do (although the gap between them has shrunk). There’s no obvious explanation for that disparity except vaccination rates. The vaccines don’t prevent transmission very well in the age of Omicron but they do a bang-up job of preventing severe illness. Regions where people are less likely to be vaxxed are likely to see steeper death tolls, which probably explains the divergence in the graph above.

Even in blue jurisdictions, it may be that Republicans there are dying disproportionately. Leonhardt points to Ocean County, New Jersey, a conservative oasis in a very liberal state. Ocean County has seen a higher death rate than the state of Mississippi due to the fact that only slightly more than half of residents are vaccinated.

Let’s end with this (sort of) upbeat note, proof that Republicans retain confidence in *some* vaccines despite their skepticism of the COVID vaccines. A few days ago data from YouGov seemed to show that GOPers now oppose mandating vaccines of any sort for children. Not true, it turns out. A majority still support mandating vaccines for measles, mumps, and rubella. Although even here, you’ll note, Republican support for that is almost 20 points less than it is among Democrats.

The results can be seen here. 71% of Americans think “parents should be required” to have their kids vaccinated against measles, mumps & rubella; 58% for “infectious diseases”; and 48% (a plurality!) for covid-19. GOP is 62-24 against covid-19 school vax mandates, pic.twitter.com/6QSm9vBzKb

— G. Elliott Morris (@gelliottmorris) February 17, 2022