Category Archives: Coronavirus

Critics of the use of ivermectin for prevention or treatment for COVID-19 point out potential flaws in the supportive scientific studies. A few of these critiques are:

• small size of experimental and control groups
• lack of a reasonable control group; e.g., if everybody in the U.S. is vaccinated for COVID-19, we won’t have a control group to help us determine true long-term consequences of vaccination or lack thereof
• not accounting for changes concurrent with the experiment; e.g., lockdowns, mask-wearing compliance, natural waxing/waning of viral surges
• excessively complicated study design; e.g., using doxycycline or azithromycin or a steroid along with the ivermectin
• the chosen doses of ivermectin are all over the map

The non-standard doses of ivermectin are maddening, but understandable. We’re trying to re-purpose a drug that’s already FDA-approved for several indications. Physicians already prescribe numerous drugs where the dose depends on age, weight, renal function, liver function, etc. Big Pharma spends millions of dollars per drug to figure this out when a drug is patent-able. But who’s going to pay for that when the drug is off-patent, like ivermectin? It’d be nice if the CDC or FDA did. We’re already a 18 months into this pandemic.

If ivermectin works at all for COVID-19, the dose for prevention may be different than for treatment. The following are some oral doses I’ve run across, mostly from positive clinical studies. “Kg” means body weight in kilograms. “Mg” means milligrams. If you can’t convert between milligrams and micrograms in your head, do it here. Many ivermectin proponents recommend starting treatment early, especially if there are co-morbidities.

Prevention of COVID-19

• at least 150 microgram/kg per week
• 12 mg (~150 microgram/kg) monthly or every 42 days
• 0.2 mg/kg (200 mcg/kg) by mouth for two consecutive days every 15 days (Brazil study by Kerr, et al)

Treatment of COVID-19 Whether or Not Hospitalized

• 200 to 1200 microgram/kg daily for three to seven days
• 0.2 mg/kg (200 microgram/kg) on Day 1 and Day 3 (plus Days 6 and 8 “if not recovered”)
• 400 microgram/kg (max of 24 mg) on Days 1 through 4 (Caution: study by Elgazzar et al is under investigation for misconduct)
• 18 to 36 mg daily or every other day for between 1 and 5 doses (Drs Orient and Vliet with help from McCullough)
• 0.4-0.6 mg/kg daily for five days or until recovered (I-MASK+ and MATH+)
• 1% injectable livestock solution: 3 mL per 110 pounds of body weight taken ORALLY for five days or until symptoms abate (Ann Barnhardt)

Treatment of COVID-19 in Hospitalized Patients

• 200 microgram/kg on Day 1 (plus 200 microgram/kg on Day 7 at physician’s discretion) (Broward Health hospitals study)
• single dose of 0.15 to 0.4 mg/kg
• 200 microgram/kg single dose
• 400 microgram/kg (max of 24 mg) on Days 1 through 4 (Caution: study by Elgazzar et al is under investigation for misconduct)

See, doses vary wildly. And don’t ask me if dose should be based on ideal rather than actual body weight.

You probably know that you can often get ivermectin without a prescription. Many countries have decided it’s safe enough to sell over-the-counter.

I’m not recommending ivermectin to you or anybody else. I’m not your doctor. Only your personal physician who knows you, your lab results, your physical exam, and your medical history is in a position to recommend drug therapy.

Steve Parker, M.D.

Updated Jan 20, 2022

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Israel has a very high COVID-19 vaccination rate: 78% of those 12 and older are fully vaccinated, nearly all with the Pfizer/BioNTech product. Yet they’re having a major surge with the delta variant.

Remember, the EUA vaccines were sold to us originally as preventing severe disease and death. We know they don’t prevent much infection, if any.

An article at Science notes that: “As of 15 August, 514 Israelis were hospitalized with severe or critical COVID-19, a 31% increase from just 4 days earlier. Of the 514, 59% were fully vaccinated. Of the vaccinated, 87% were 60 or older.”

Why the surge? One theory is that immunity conferred by the vaccine is waning over time. Israel is recommending a booster shot for those over 50 and six months past the original 2-shot vaccination.

The article concludes:

Yet boosters are unlikely to tame a Delta surge on their own, says Dvir Aran, a biomedical data scientist at Technion. In Israel, the current surge is so steep that “even if you get two-thirds of those 60-plus [boosted], it’s just gonna give us another week, maybe 2 weeks until our hospitals are flooded.” He says it’s also critical to vaccinate those who still haven’t received their first or second doses, and to return to the masking and social distancing Israel thought it had left behind—but has begun to reinstate.

Aran’s message for the United States and other wealthier nations considering boosters is stark: “Do not think that the boosters are the solution.”

Given the known and unknown risks of the vaccines, if I were one of the tyrants mandating vaccination I would rescind my order.

Steve Parker, M.D.

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For Details, see Ohio Capital Journal on Aug 30, 2021:

A Butler County judge ruled in favor of a woman last week who sought to force a hospital to administer Ivermectin — an animal dewormer that federal regulators have warned against using in COVID-19 patients — to her husband after several weeks in the ICU with the disease.

Butler County Common Pleas Judge Gregory Howard ordered West Chester Hospital, part of the University of Cincinnati network, to treat Jeffrey Smith, 51, with Ivermectin. The order, filed Aug. 23, compels the hospital to provide Smith with 30mg of Ivermectin daily for three weeks.

A number of taxpayer-funded state authorities would not comment on the case. But don’t worry, they won’t miss a paycheck.

The article has a graph showing the number of ivermectin prescriptions dispensed from retail pharmacies in the U.S. from March 2019 to mid-August 2021. A large spike in prescriptions started in early July 2021, leading to almost 90,000 prescriptions in the weak of Aug 13.

Some pharmacists refuse to fill ivermectin prescriptions for COVID-19.

Steve Parker, M.D.

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It’s probably just a matter of time before YouTube disappears this video since it is subversive to the MSM and political narrative. Don’t focus too much on Guillain-Barre Syndrome. The important points are misleading propaganda, the hasty roll-out of the swine flu vaccine, government malfeasance, and apparent lying by a former head of the CDC. Enjoy!

I thank WordPress for not censoring me. I hope it’s not because my readership is so minuscule that I’m not on their radar screen!

New Microbes and New Infections, volume 43, September 2021

The five authors conclude that ivermectin (IVM) is effective in both treatment and prevention of COVID-19. They write that it cuts mortality of the disease by somewhere between 20 and 67%. “Six of seven meta-analyses of IVM treatment RCTs reporting in 2021 found notable reductions in COVID-19 fatalities, with a mean 31% relative risk of mortality vs. controls.” The authors are not saying it’s a miracle cure for everyone.

Preventative doses reduce the incidence of symptomatic COVID-19 between 20% (150 microgram/kg weekly) and 50% (12 mg dose (~150 microgram/kg) given once for 42 days of coverage).

We have plenty FDA-approved drugs with similar efficacy numbers.

How does IVM work? “A likely biological mechanism has been indicated to be competitive binding with SARS-CoV-2 spike protein sites….”

A few excerpts:

Recently, Dr Satoshi Omura, the Nobel co-laureate for the discovery of IVM, and colleagues conducted a comprehensive review of IVM clinical activity against COVID-19, concluding that the preponderance of the evidence demonstrated major reductions in mortality and morbidity. Our review of that evidence, updated with consideration of several new studies, supports the same conclusion.

IVM has been used safely in 3.7 billion doses worldwide since 1987 and is well tolerated even at much greater doses than the standard single dose of 200 μg/kg. It has been used in randomized controlled trials for COVID-19 treatment at cumulative doses of 1500 μg/kg, 1600 μg/kg and 3000 μg/kg over 4 or 5 days with only small percentages of mild or transient adverse effects.

Why not RTWT? Note the Peruvian experience. Also see the post-post-postscript (PPPS) and post-post-post-postscripts (PPPPS) below if you want to be totally and uncomfortably mystified.

Steve Parker, M.D.

PS: One of the five authors (TJB) “is a principal in Topelia Therapeutics (Ventura, California), which seeks to commercialize cost-effective treatments for COVID-19, including IVM. All other authors report no conflicts of interest.” Some of you will also discount the reliability of this article because P.A. McCullough is one of the authors.

PPS: One thing I noticed while reading some of the references for the main article is that some investigators define COVID-19 infection as a positive PCR or a new positive antibody test, regardless of symptoms. Do you care much if you feel fine but one of those tests are positive? Most folks don’t. (I’ll admit those tests may have some clinical and public health research applications. Remember that if the cycle threshold on the PCR test is set too high (over 25-30?), the test is wildly inaccurate. Next time you get a COVID-19 PCR test, ask for the cycle threshold. You won’t get an answer.

PPPS: One of the pre-print articles cited by the authors was withdrawn by the publisher (Research Square) In July 2021 and is under investigation (by the publisher, I guess). Click for details at The Guardian.

PPPPS: From Cochrane July 28, 2021:

“Based on the current very low- to low-certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID-19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use of ivermectin for treatment or prevention of COVID-19 outside of well-designed randomized trials.”

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From Science Daily:

A new study published in the journal Nature estimates that 103 million Americans, or 31 percent of the U.S. population, had been infected with SARS-CoV-2 by the end of 2020. Columbia University Mailman School of Public Health researchers modeled the spread of the coronavirus, finding that fewer than one-quarter of infections (22%) were accounted for in cases confirmed through public health reports based on testing.

In Israel, 78% of the population over age 12 is fully vaccinated against COVID-19, with the Pfizer/BioNTech product. Nevertheless, the country his seeing a major surge in cases, particularly the delta variant. This variant is also the dominant one in the U.S. this summer.

Viruses cannot replicate without a living host to provide the cellular hardware for reproduction. With “herd immunity,” the virus can’t find enough hosts within which to replicate. Dr Fauci and other “authorities” are still telling us that once 70-75% of the population is vaccinated, we’ll have herd immunity and the virus will peter out.

Wrong….once again.

Plenty of vaccinated folks in Israel are getting infected (aka breakthrough cases) and spreading the virus to others.

From ScienceMag.org:

What is clear is that “breakthrough” cases are not the rare events the term implies. As of 15 August, 514 Israelis were hospitalized with severe or critical COVID-19, a 31% increase from just 4 days earlier. Of the 514, 59% were fully vaccinated. Of the vaccinated, 87% were 60 or older. “There are so many breakthrough infections that they dominate and most of the hospitalized patients are actually vaccinated,” says Uri Shalit, a bioinformatician at the Israel Institute of Technology (Technion) who has consulted on COVID-19 for the government. “One of the big stories from Israel [is]: ‘Vaccines work, but not well enough.’”

A problem with the Pfizer vaccine is that its protection against severe disease wanes over time. What about vaccine protection against death? Time will tell.

Israel politicians cut a supply deal with Pfizer early-on, and the population jumped on the vaccination bandwagon enthusiastically. At this point many of the vaccinees are over six months out from their original jabs. Pfizer admits that protection drops over time, hence the recommendation for booster shots periodically

Forbes reports that:

Recent data from Israel’s health ministry suggests Pfizer’s Covid-19 vaccine is far less effective at preventing infection and symptomatic illness with the Delta variant than with previous strains of coronavirus, a finding that conflicts with other research indicating high levels of protection against the contagious variant as countries around the world struggle to contain new waves of infection.

A full course of the Pfizer-BioNTech vaccine was just 39% effective at preventing infections and 41% effective at preventing symptomatic infections caused by the Delta Covid-19 variant, according to Israel’s health ministry, down from early estimates of 64% two weeks ago. 

The figures, based on data from an unspecified number of people between June 20 and July 17, are significantly lower than previous estimates of the vaccine’s efficacy against other variants, which initial clinical trials found to be 95%.

I haven’t read much yet about the breakthrough infection rate in those who took the non-Pfizer vaccines, such as Moderna, J&J, and AstraZeneca. I think the latter is not available in the U.S. In Arizona where I live, Pfizer and Moderna dominate the market.

Does natural immunity from infection provide better protection than the vaccines? I’m not sure, but I bet it does. For what it’s worth, I don’t recall seeing a patient with a second COVID-19 infection after having it once. But I’ve treated several patients who failed to be protected by the vaccines.

It’s time to face the possibility that we’ll never have great vaccines against COVID-19, just like we don’t have great vaccines against the common cold and the flu. At least the flu vaccines seem to be much safer than the COVID-19 vaccines. COVID-19 may become endemic rather than pandemic, with luck mutating to less virulent variants.

It looks like we’re never getting to herd immunity via the current vaccines. I hope I’m wrong.

Steve Parker, M.D.

PS: Can we skip our flu vaccines this Fall since flu has disappeared?

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Not my creation. If this is yours and you don’t want it disseminated, let me know.

Gibralter is pandemic-famous for being the first nation to vaccinate its entire adult population. The effort only took nine weeks and was completed in March 2021. Gibralter has only 34,000 inhabitants in its 2.6 square miles.

So Gibralter should be wide open an back to normal life now, right?

Guess again.

A couple weeks ago, the CDC added Gibralter to its “very high COVID-19 risk” list. CDC recommends not traveling to countries on the list. The linked article at WDSU.com notes that:

Destinations that fall into the “very high” risk category have had more than 500 cases per 100,000 residents in the past 28 days, according to CDC parameters.

These vaccines are increasingly looking like a pig in a poke.

Steve Parker, M.D.

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