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Beth Mole-August 27, 2021 at 12:59 AM UTC

In the current wave of COVID-19 driven by delta, officials have noticed a surge in the risk of misusing deworming drugs commonly used in domestic animals. As a result, the number of calls received from the poison control center increased, the shelves of agricultural supply stores were empty, and the regulatory agencies also made demands.

In a compelling tweet over the weekend, the U.S. Food and Drug Administration bluntly wrote: "You are not a horse. You are not a cow. Seriously, you all stop."

The agency emphasized that the drug ivermectin has not been approved by the FDA for the treatment or prevention of COVID-19. So far, there is no evidence that it can play any of the above-mentioned effects. However, the agency warned that it can cause serious side effects and overdose, which can be life-threatening. Overdose can cause nausea, vomiting, diarrhea, low blood pressure (hypotension), allergic reactions (pruritus and hives), dizziness, ataxia (balance problems), seizures, coma, and even death.

Before the pandemic, Ivermectin had been used to prevent and treat parasitic infections in humans and animals for decades. At low concentrations, the drug interferes with specific ion channels in parasitic nematodes, but does not interfere with ion channels in humans or animals. Disruption of ion channels in nematodes can cause paralysis and prevent the nematodes from eating and reproducing. Therefore, Ivermectin is commonly used in small animals, such as dogs and cats, to prevent heartworm infection. In large livestock animals (including cattle, horses, pigs, and sheep), it is used as an anthelmintic.

In humans, the FDA has approved ivermectin tablets for the treatment of diseases caused by parasitic intestinal worms, as well as topical preparations for the treatment of certain external parasites (such as head lice). It is important to note, however, that the dose of ivermectin available to people is relatively small, and its formulation is known to be safe for human use. On the other hand, over-the-counter livestock drugs are not formulated for human use and have larger doses for the larger bodies of animals. At higher concentrations, ivermectin not only begins to interfere with nematode ion channels, but also begins to interfere with other types of key channels in humans and animals, such as neurotransmitter channels. This can be very dangerous.

During the pandemic, the researchers highlighted data indicating that ivermectin may also have antiviral activity. Preliminary data indicate that the drug can stop the pandemic coronavirus SARS-CoV-2-at least in a petri dish. Specifically, Ivermectin seems to block the key intracellular transporter that SARS-CoV-2 uses to invade human cells. The drug may also interfere with the ability of the virus to attach to human cells through its spike protein.

But the Petri dish data has not yet been transformed into any convincing clinical data, indicating that the drug is actually useful for COVID-19 in the whole person. Research on humans is small and has produced inconsistent results. Meta-analyses designed to eliminate potential clinical benefits have been battling erroneous data, and some have been withdrawn.

In addition, researchers have reason to suspect that further research will prove that Ivermectin is effective against COVID-19. As the National Institutes of Health pointed out in its clinical guidelines, drug research has shown that making the blood concentration of ivermectin high enough to replicate the SARS-CoV-2 obstructive effect observed in a petri dish would “need to give up to 100 times the dose" than those approved for use in humans. "

All of this has not stopped COVID misinformation factories on the Internet from promoting the drug—and people buying it. For months, the FDA has been warning about abuse. But in the context of the surge of delta coronavirus variants, the abuse of ivermectin has escalated to alarming levels.

In Thursday’s health alert, the Centers for Disease Control and Prevention warned that prescriptions for ivermectin have soared this month. Those who cannot obtain prescriptions for drugs can only purchase over-the-counter livestock drugs and clean up the supplies in the farmer’s store. Conversely, in recent weeks, the poison control center has received a surge in calls related to ivermectin, and reports of serious illnesses caused by overdose have also increased.

According to a recent analysis, during the week ending January 8 this year, when COVID-19 cases surged, the average weekly prescription rate of ivermectin increased from 3,600 prescriptions before the pandemic to 39,000 prescriptions. Peak. The CDC noted that since the beginning of July, the amount of ivermectin dispensed has surged again along with COVID-19 cases, reaching more than 88,000 prescriptions in the week ending August 13. This means a 24 times increase from the pre-pandemic baseline.

With the boom in drugs, poisoning incidents also followed. The CDC reported that in January, compared with the pre-pandemic baseline, poison control centers across the United States received three times the number of calls related to ivermectin. In July, the call volume of ivermectin continued to increase sharply, five times higher than the baseline. These calls are also related to the increase in the number of ivermectin-related emergency department and hospital visits.

The CDC alert highlighted two cases in which an adult drank an injectable ivermectin preparation for cattle in an attempt to prevent COVID-19 infection. The person developed confusion, lethargy, visual hallucinations and tremors, and spent 9 days in the hospital. Another adult was hospitalized after taking ivermectin tablets of unknown strength purchased from the Internet. The person took five pills a day for five consecutive days and experienced "mental changes". They were lost and unable to answer questions or follow orders.

In a report on Wednesday, USA Today noticed a state-level trend in poison control center calls. For example, in Florida, there were 27 ivermectin-related calls to the poison control center in August, compared with 11 in July. From January to June, there are only six calls in total. Similarly, in Texas, the State Poison Control Center received 150 calls about ivermectin this year, 55 of which were in August. In Georgia, the poison control center usually receives a phone call related to ivermectin every month. So far this month, it has recorded about 15 of them.

In Arkansas, officials also noticed an increase in ivermectin-related calls to the state’s poison control center. An official in Washington County, Arkansas, was particularly shocked to learn that health care providers at the county detention center had been prescribing ivermectin to prisoners and county employees. Since the beginning of the pandemic, more than 500 prisoners at the center have tested positive for COVID, and an unknown number of them have received the drug.

Dr. Rob Callas, a medical provider at the center, told a local CBS subsidiary that he took ivermectin himself and gave it to many of his family members. The Arkansas Medical Commission has since started investigating the case.

Despite this, some national leaders continue to send out dangerous messages about the drug. In a Thursday tweet related to the Karas case, Arkansas Rep. Robin Lundstrum wrote: “Doc saved 500 prisoners’ lives, taxpayers’ money and saved bed space! Let’s pay tribute to Doc and Sherriff, and Not thank them!"

Also in Alaska, Kenai Peninsula borough mayor Charlie Pierce continued to promote and defend the use of ivermectin, saying in a radio interview: "Let the doctor try something that has not been approved by the Food and Drug Administration."

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