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Treatments for COVID-19: Current consensus

A note on WP:MEDRS: Per this Misplaced Pages policy, we must rely on the highest quality secondary sources and the recommendations of professional organizations and government bodies when determining the scientific consensus about medical treatments.

1. Ivermectin: The highest quality sources (1 2 3 4) suggest Ivermectin is not an effective treatment for COVID-19. In all likelihood, ivermectin does not reduce all-cause mortality (moderate certainty) or improve quality of life (high certainty) when used to treat COVID-19 in the outpatient setting (4). Recommendations from relevant organizations can be summarized as: Evidence of efficacy for ivermectin is inconclusive. It should not be used outside of clinical trials. (May 2021, June 2021, June 2021, July 2021, July 2021) (WHO, FDA, IDSA, ASHP, CDC, NIH)
2. Chloroquine & hydroxychloroquine: The highest quality sources (1 2 3 4) demonstrate that neither is effective for treating COVID-19. These analyses accounted for use both alone and in combination with azithromycin. Some data suggest their usage may worsen outcomes. Recommendations from relevant organizations can be summarized: Neither hydroxychloroquine nor chloroquine should be used, either alone or in combination with azithromycin, in inpatient or outpatient settings. (July 2020, Aug 2020, Sep 2020, May 2021) (WHO, FDA, IDSA, ASHP, NIH)
3. Ivmmeta.com, c19ivermectin.com, c19hcq.com, hcqmeta.com, trialsitenews.com, etc: These sites are not reliable. The authors are pseudonymous. The findings have not been subject to peer review. We must rely on expert opinion, which describes these sites as unreliable. From published criticisms (1 2 3 4 5), it is clear that these analyses violate basic methodological norms which are known to cause spurious or false conclusions. These analyses include studies which have very small sample sizes, widely different dosages of treatment, open-label designs, different incompatible outcome measures, poor-quality control groups, and ad-hoc un-published trials which themselves did not undergo peer-review. (Dec 2020, Jan 2021, Feb 2021)

Pure propaganda

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

That picture and caption with the horse reads like propaganda from one of the former Soviet bloc countries, it certainly has no place at the beginning of the article. There's over 40 research papers which have identified Ivermectin as effective in the treatment of COVID. Monash University is one of them, though they said it was initial research. The original paper is here "The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro".

Here is an extract from a research institute in Japan written in Japanese:

Approximately 80 clinical trials have been reported, mainly in developing countries, that ivermectin, a silver bullet for antiparasitic diseases discovered by Dr. Satoshi Omura of Kitasato University, is effective against coronavirus infection (COVID-19).

Many doctors in the United States and the United Kingdom have insisted that they be used for prevention and treatment as "effective", but pharmaceutical companies and government authorities are also moving to prevent their use, saying that "clinical trials are insufficient".

Japan has approved the use of ivermectin for the treatment of COVID-19, subject to the agreement of doctors and patients, but there is no intention to actively approve it. We should take the initiative in confirming the effects of the drug.

The Indian Bar Association sued the WHO for misleading the public on Ivermectin. Ivermectin has been used in abundance in Indian states like Uttar Pradesh and they have some of the lowest numbers of COVID cases in the country.

I like to assume good faith in our editors but I'm seeing the same couple of editors putting out this propaganda on Misplaced Pages and trashing articles on anybody who has spoken out against the vaccine. ₪ Encyclopædius 17:27, 27 December 2021 (UTC)

Misplaced Pages follows reliable sources, especially for medical claims, and you have produced none. Ivermectin is now just the province of quacks, fools & grifters as our sources tell us. The FDA tweet is a significant part of the story covered in multiple RS, and the horse picture adds nice colour and sets the scene. I commend it! Alexbrn (talk) 17:33, 27 December 2021 (UTC)

Antiviral Research Volume 178, June 2020 is very much a reliable source. No, the media tells us it's the province of quacks, fools and grifters because they're pushing the agenda that only the vaccine can save people. There's numerous respectable papers which have been published on this.₪ Encyclopædius 17:38, 27 December 2021 (UTC)

Hi, we're not basing our evaluation of sources on the "media" interpretation or "agenda" as you claim here. We're basing it on the preponderance of views expressed in the most reliable and widely circulated academic review articles and systematic meta-analyses from topic-relevant scientific journals. Please see the template at the top of this page for more information. — Shibbolethink 18:10, 27 December 2021 (UTC)

Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: A matched case-control study National Library of Medicine. "Two-dose ivermectin prophylaxis at a dose of 300 μg/kg with a gap of 72 hours was associated with a 73% reduction of SARS-CoV-2 infection among healthcare workers for the following month. "₪ Encyclopædius 17:40, 27 December 2021 (UTC)

Please see WP:MEDRS for guidance of reliable sources for medical claims. To save time, some excellent WP:MEDRS are listed in the box at the head of this page. Alexbrn (talk) 17:46, 27 December 2021 (UTC)

Ivermectin has been extensively used to treat COVID in countries like India and Japan. Do you dispute this?₪ Encyclopædius 17:49, 27 December 2021 (UTC)

It's been attempted in India, with no credible evidence of success. The Japan stuff is bogus, as covered in the article. Alexbrn (talk) 17:53, 27 December 2021 (UTC)

“Uttar Pradesh was the first state in the country to introduce large-scale prophylactic and therapeutic use of Ivermectin. The India Express via MSN.₪ Encyclopædius 17:55, 27 December 2021 (UTC)

https://gidmk.medium.com/ivermectin-didnt-save-uttar-pradesh-from-covid-19-17684f49d8b3

Dec 29, 2021

Ivermectin Didn’t Save Uttar Pradesh From Covid-19

We don't have reliable covid-19 data from developing countries like India.

--91.159.188.74 (talk) 18:59, 15 February 2022 (UTC)

Quote: "He said that apart from aggressive contact tracing and surveillance, the lower positivity and fatality rates may be attributed to the large-scale use of Ivermectin use in the state, adding that the drug has recently been introduced in the National Protocol for Covid treatment and management. “Once the second wave subsides, we would conduct our own study as there has been an emerging body of evidence to substantiate our timely use of Ivermectin from the first wave itself,” Vikasendu told The Indian Express. — Preceding unsigned comment added by Encyclopædius (talk • contribs)

Philippine Daily Inquirer : "Uttar Pradesh is ivermectin’s best practice success story" In two weeks’ time, the cases in the ivermectin-using states started to drop by half, and in six weeks, they achieved 85- to 90-percent reduction in cases. In three months, the cases further decreased by 95 percent to 99.9 percent compared to peak levels. For several months now, many states are enjoying near-normal, pre-COVID activities. ₪ Encyclopædius 18:06, 27 December 2021 (UTC)

We've had soooo many discussions about this topic. It's clear that you have no understanding of WP:MEDRS, which means that we don't cite individual trials. I endorse what Alexbrn has said above. Hemiauchenia (talk) 17:51, 27 December 2021 (UTC)

I fail to see how the BBC is a reliable source for assessing the effectiveness of Ivermectin, while the research of actual scientists says otherwise though..₪ Encyclopædius 17:53, 27 December 2021 (UTC)

I agree. Good job the BBC is not used for that purpose then. (It is however, a good source to report on the burgeoning research fraud scandal around ivermectin/COVID). Alexbrn (talk) 17:56, 27 December 2021 (UTC)

Why are you complaining about the BBC not being a reliable source then approvingly citing The India Express and Philippine Daily Inquirer? Hemiauchenia (talk) 18:11, 27 December 2021 (UTC)

Even the BBC has said Though there have been some early "promising" results from small and observational studies, though Prof Richard Hobbs said it would be "premature" to recommend Ivermectin for Covid. Sorry but I'm not seeing anything which convinces me this is just nonsense from conspiracy quacks.₪ Encyclopædius 18:13, 27 December 2021 (UTC)

The prevailing view is that it should only be used in clinical trials, but that the data from large trials so far is not looking good. That's what MEDRS tell us. — Shibbolethink 18:14, 27 December 2021 (UTC)

I'm not approving of any source, I'm simply pointing out that mainstream sources in those countries have reported that Ivermectin has been effective or shows a lot of promise and I don't think it's right to imply that it is just utter nonsense spouted by loony anti vaxxers/conspiracy theorists. ₪ Encyclopædius 18:13, 27 December 2021 (UTC)

Okay, well this is a talk page intended to be used for concrete and specific suggestions on how to improve the article. Do you have any of those? — Shibbolethink 18:20, 27 December 2021 (UTC)

Misplaced Pages is not to promote Big Pharma conspiracy theories and even relies on WP:MEDRS for biomedical claims. Since this talk page is not a forum (WP:NOTFORUM), unless you provide MEDRS quality sources, not much can be done. Other kinds of general RS can also be good to report that some are still pushing for its use despite the lack of evidence for its efficacy and that already appears to be covered: "Despite the absence of high-quality evidence to suggest any efficacy and advice to the contrary, some governments have allowed its off-label use for prevention and treatment of COVID‑19. ". —PaleoNeonate – 19:00, 27 December 2021 (UTC)

Misplaced Pages should strive to report fact and truth from a neutral perspective. A picture of a horse and a Twitter quote which pokes fun at the situation is not neutral. We should mention large-scale use in Uttar Pradesh and that it was listed on the National Protocol for Covid treatment and management but later removed. ₪ Encyclopædius 19:33, 27 December 2021 (UTC)

The FDA "horse" tweet is reliably-sourced and had much secondary coverage, so is ideal for inclusion. You have produced zero reliable sources in support of your fringe POV. Alexbrn (talk) 19:35, 27 December 2021 (UTC)

Oh, the Uttar Pradesh trash, which has been debunked. --Julius Senegal (talk) 19:37, 27 December 2021 (UTC)

You think Newswise.com is a leading authority on judging the success of Ivermectin? ₪ Encyclopædius 19:43, 27 December 2021 (UTC)

Why no WP:INDENT? Is this some kind of trolling? You have still produced zero reliable sources but are pushing medical misinformation. Shame on you; it's a fucking disgrace. Alexbrn (talk) 19:49, 27 December 2021 (UTC)

Horse image

May I suggest removing the horse image and going back to the tweet box? I am worried the horse image gives off a userspace essay vibe. –Novem Linguae (talk) 10:13, 30 December 2021 (UTC)

Done - but I rather liked the horse. Trying to think of another image that sums up the whole topic ... Alexbrn (talk) 10:19, 30 December 2021 (UTC)

Thanks for the quick response. File:Ivermectin tablets (51710488204) (cropped).jpg is boring, but would fit the article. –Novem Linguae (talk) 10:21, 30 December 2021 (UTC)

What would be really good is a pic of someone sorting ivermectin tablets, or stockpiling them. The tablets themselves instead of the box... I'll see if I can find something CC or take it myself at the pharmacy... — Shibbolethink 15:44, 30 December 2021 (UTC)

I think it would be appropriate to have the horse at a different place in the article. Thoughts? Just not as the top image — Shibbolethink 15:43, 30 December 2021 (UTC)

I disagree. It adds nothing educational in context (the reader doesn't need to see what a horse looks like to understand the article), and visually reinforces the message that Ivermectin is only for horses, which is misinformation. --Animalparty! (talk) 14:22, 3 January 2022 (UTC)

That makes sense. I think the tweet template is fine, then — Shibbolethink 16:48, 3 January 2022 (UTC)

section needing clarity

I think the section Scientists targeted needs attention for accuracy and context. As written it appears to imply that Hill himself committed some unspecified fraud (Hill posted video, "serious methodological limitations" identified, research fraud emerges, Hill revises findings). The BMJ-EBM piece, after discussing several flawed or inconclusive studies, only mentions Hill et al.'s preprint in a reference, following the statement: "Concluding, research related to ivermectin in COVID-19 has serious methodological limitations resulting in very low certainty of the evidence, and continues to grow", citing 3 studies, one of which is Hill et al. From this one could reasonably infer several things: that the 3 studies represent more examples of "serious methodological limitations"; that they represent growing "research related to ivermectin in COVID-19"; that they collectively comment on methodological limitations; or some combination of the three. The distinction is not clear. It does not explicitly say Hill et al.'s findings are cast into doubt, although other sources likely support this. Even when that's clarified, the leap between "methodological limitations" and "fraud" is not made, such that the next sentence "As the research fraud emerged, Hill revised his analysis to discount it." is jarring and confusing: where was fraud previously mentioned? Did Hill revise his analysis to discount the fraud or his own earlier analysis? An ideal article should be fully comprehensible to general Misplaced Pages readers who aren't versed in the nitty gritty and who's-who of ivermectin research. And lastly, the header "Scientists targeted" implies more than one scientist, but the section only mentions attacks received by Hill. --Animalparty! (talk) 20:06, 3 January 2022 (UTC)

I don't think the "methodological limitations" stuff is worth retaining - it only refers to a prior version of a paper which was subsequently revised in any case. Alexbrn (talk) 20:08, 3 January 2022 (UTC)

"Fraud" is still unspecified, and mentioned only in lead and this sentence. --Animalparty! (talk) 21:13, 3 January 2022 (UTC)

The Guardian, anti-vax, right-wing, conspiracy theorists

Cause celebre is never used in the source. A strange choice of word. The characterizations here are a direct quote from one person. Probably shouldn't be stated in wikivoice when we are quoting a medical student named Jack Lawrence. Rightwing appears unquoted once in the article, but they never say who these right-wingers are except for naming a conservative Australian MP. Please reconsider the application of this source in the article. Not a big fan of “nevertheless” in the lead either. SmolBrane (talk) 23:04, 12 January 2022 (UTC)

The source isn't quoting a student. It says "The efficacy of a drug being promoted by rightwing figures worldwide ..." in its own voice. The lede should summarize the article and we definitely need something about the continued promotion, though I don't care about "right-wing" so that can go in my view. Note this was discussed before. Alexbrn (talk) 17:07, 13 January 2022 (UTC)

The way this is cited it definitely looks like we are quoting Jack Lawrence, there are probably better ways to cite this. Cause celebre should go, it's not English, it's not used by the source, and in my opinion it doesn't have use in common parlance. Given that it is your phrasing on the three articles it appears(originating here: ) I would simply ask you to copyedit this. MOS:EDITORIAL says 'nevertheless' should go, clearly. SmolBrane (talk) 21:25, 18 January 2022 (UTC)

Cause celebre has been used in English for a long time. As the saying goes:

English has pursued other languages down alleyways to beat them unconscious and riffle their pockets for new vocabulary.

I refrain from commenting on the rest of the suggestions at this time. — The Hand That Feeds You: 21:55, 18 January 2022 (UTC)

MOS:EDITORIAL doesn't mention "nevertheless", WP:CLEARLY or not. Pretty much every thing you have said seems to be wrong. That a particular wording is "not used by the source" is a good thing, because we are meant to summarize in our own word and not plagiarize. I would not mind "focus" or "obsession" instead, mind. Alexbrn (talk) 22:04, 18 January 2022 (UTC)

"cause celebre" is a fair summary of the source in my opinion. They celebrated and promoted the drug's use in COVID treatment, despite its lack of efficacy. As Alexbrn said, there is no quoting of any medical students here. — Shibbolethink 19:54, 19 January 2022 (UTC)

Lol this was elucidating, to say the least. Thanks for the replies. SmolBrane (talk) 03:27, 20 January 2022 (UTC)

Can we call it "safe" in the lede + are we accurately interpreting the Bloomberg source

My edits were reverted here: https://en.wikipedia.org/search/?title=Ivermectin_during_the_COVID-19_pandemic&type=revision&diff=1070502520&oldid=1070499080

The reason I thought these would improve the page is (for the "safe" edit): that a reader may not realize why it's controversial, since it's a safe drug, and that "risks" have more to do with how if the drug is ineffective, if people at risk of dying from covid are taking it instead of the vaccines which are proven to reduce death and hospitalization, they could be harmed, and (for the "profit" edit): the Bloomberg article doesn't make the claim that profits were significantly increased. If Ivm. is generic, that's a bold claim. Anyone can make it and sell it, as there is no exclusive patent anywhere. Assuming a free market, that is what happens in a capitalist system--prices go down, and the consumer benefits. The source makes one indirect reference to profit, but provides no figures, nor the claim that profits were significantly increased. The case for increased revenue, on the other hand, is backed up by the source. — Preceding unsigned comment added by IVERMECTIN ADDICT (talk • contribs) 20:16, 7 February 2022 (UTC)

No drug is 100% safe for all uses, and, with this article being about this drug's use to treat COVID-19 rather than about its use as an antiparasitic drug, the word "safe" would appear to be actively misleading. And, by basic economics, increased demand for anything leads to increases in both revenue and profit in the short term in a free market. Nobody, and no company, can step up supply immediately. Phil Bridger (talk) 20:35, 7 February 2022 (UTC)

There are two issues here; the first one is profit. Increased revenue does not necessarily imply increased profits. That's original research. If a supplier is taking a loss on each sale, for example, then they are seeing decreased profits as revenue increases. Moreover, in a highly regulated industry like pharmaceuticals, the price equilibrium can be disrupted by legal requirements that a drug be sold at a specific price, regardless of supply constraints or increasing demand. All that is to say that we cannot infer that profits increased absent a source that says just that. Per WP:PROVEIT, it should say revenue. The second issue is safety. A drug's "safety" also usually depends on dosage, and in the case of Ivermectin, we have people using way too much of it and harming themselves. It would be irresponsible to call it "safe" in Misplaced Pages's voice with no qualifications. It should not be called safe in the lead as it was in the disputed edit. AlexEng 22:34, 7 February 2022 (UTC)

I have no particular issue with revenue vs profit (though the source does mention companies are "cashing in" and that one company enjoyed a "bonanza", which gives a strong steer as to what they think happened). It was the (now blocked) OP however who restored "profit" with this edit so one wonder what was going on. Trolling probably. But as to safety, yeah, calling it flatly "safe" in the context of this article is irrelevant/misleading; also a WP:LEDEBOMB. Alexbrn (talk) 06:15, 8 February 2022 (UTC)

Ivermectin does not work as an antiviral in humans

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

https://www.acsh.org/news/2021/12/02/how-does-pfizers-paxlovid-compare-ivermectin-15967

Ivermectin does not work as an antiviral in Humans (only in lab).

IF ivermectin is proven to be an effective Covid treatment, it must be acting by some yet-unknown mechanism.

Perhaps killing the PARASITES in your body gives some protection against covid-19, so one can travel to a country selling ivermectin OTC, eat the pills, travel back to home country and get some protection?

In developing countries they have problems with human parasites.

In India, ivermectin might work, but we need better studies than this:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8417612/

Same study:

https://www.cureus.com/articles/64807-prophylactic-role-of-ivermectin-in-severe-acute-respiratory-syndrome-coronavirus-2-infection-among-healthcare-workers

--91.159.188.74 (talk) 02:22, 16 February 2022 (UTC)

Semi-protected edit request on 16 February 2022

This edit request has been answered. Set the |answered= or |ans= parameter to no to reactivate your request.

In the section entitled "Covid Mis-Information" at your page on Ivermectin (https://en.wikipedia.org/Ivermectin#COVID-19_misinformation), in fairness to the body of research that has been produced on the topic, this medicine, and its effect on treating Covid patients, you have at the minimum an obligation to include a link to the following website : https://c19ivermectin.com/ , along with a statement that there have been 78 different research studies that examined Ivermectin's safety and effectiveness in treating Covid 19.

Presently you cite only one research paper that used only one evaluative method to evaluate only 41 total Ivermectin studies, and that paper is more than six months old. As there are a large number of other more recent studies and evaluations of Ivermectin as found in the website I list above that have come to opposite conclusions, your present entry is mis-leading and seems to reflect bias against all known information regarding Ivermectin and its effects in treatment of Covid illness.

Hence the need to balance your paragraph to allow readers the opportunity to read all available information on the topic and come to their own conclusions. Considering that there are millions of people around the world (including me) who have recovered from Covid illness with the administration of Ivermectin as a part of their therapy, by relegating their experiences to the category of "Conspiracy Theory" you are being intellectually dishonest and not serving the public interest.

You can contact me at rayfcom@optonline.net or at 516-521-5021 with any questions regarding this request.

Ray Commisso 69.114.52.141 (talk) 14:33, 16 February 2022 (UTC)

 Not done: see WP:MEDRS. Your linked website https://c19ivermectin.com/ is specifically named in this paper https://ebm.bmj.com/content/early/2021/05/26/bmjebm-2021-111678 which notes it as carrying out junk science with really no standards. Cannolis (talk) 14:41, 16 February 2022 (UTC)

Please also see Template:COVID-19 treatments (current consensus) #3, which specifically disallows the use of c19ivermectin.com, stating that expert opinion describes this website as unreliable because it violates basic methodological norms. –Novem Linguae (talk) 15:22, 16 February 2022 (UTC)

Itajai, Brazil Study.

This study shows good results with a clear indication of the study methods.

Itajai, Brazil study is well supported by external statistics and is under review. As the political heat fades and the editors and american left moved on to something else, perhaps the normal editors could have some introspection on the echo chamber they have created.

A cheap off patent drug, widely available and stocked, used in everything from dog, horses and humans is reported to work better as a treatment than an on patent drug with a millions spent to support it.

It would be the medical story of the century if a well known prevention regium with near zero cost is more effective than an on patent drug.

This drug and its covid history is just now being studied by people who are serious external to North American and EU political motivations.

"Ivermectin Prophylaxis Used for COVID-19: A Citywide, Prospective, Observational Study of 223,128 Subjects Using Propensity Score Matching"

https://www.cureus.com/articles/82162-ivermectin-prophylaxis-used-for-covid-19-a-citywide-prospective-observational-study-of-223128-subjects-using-propensity-score-matching Loopbackdude (talk) 03:58, 7 March 2022 (UTC)

Cureus is not considered a reliable journal. It is not a suitable source for inclusion on wikipedia. And, secondly, I would tell you to look at the data provided in the template at the top of this page, and see that more reputable sources are what we use to determine what should be included on wikipedia. — Shibbolethink 04:26, 7 March 2022 (UTC)

Yeah, another instance of ivermectin boosters getting their stuff published in junk journals. Meanwhile, the (genuine) science is solid. Alexbrn (talk) 06:53, 7 March 2022 (UTC)

PLOS study showing Beneficial uses of Ivermectin

https://journals.plos.org/plosone/article/peerReview?id=10.1371/journal.pone.0247163 This study meets the requirements at WP:MEDRS, and is considered a reliable high quality source. Any objections to including it in the wiki? 192.86.86.201 (talk) 05:57, 17 March 2022 (UTC)

 Not done Primary source failing WP:MEDRS. Alexbrn (talk) 06:24, 17 March 2022 (UTC)

Ivermectin and COVID-19

"Ivermectin Does Not Reduce Risk of Covid Hospitalization, Large Study Finds".

"Effect of Early Treatment with Ivermectin among Patients with Covid-19". doi:10.1056/NEJMoa2115869. {{cite journal}}: Cite journal requires |journal= (help)

2600:1000:B03F:2983:4FD:F300:B6A2:155 (talk) 22:05, 30 March 2022 (UTC)

Unfortunately a WP:PRIMARY source, but will likely be included in new secondary reviews which would be suitable for inclusion here and elsewhere on Misplaced Pages. FYI, you don't need to post on a bunch of different talk pages . This is actually frowned upon on Misplaced Pages. Better to post on one page, and see what kind of discussion ensues. Only post elsewhere if really necessary. — Shibbolethink 22:33, 30 March 2022 (UTC)

Non-neutral POV re some science PhDs in favor of ivermectin

I made an edit in one section that has a non-neutral POV: “Social Media Advocacy” under “Misinformation and Advocacy,” titles which themselves very arguably don’t have a NPOV. Regardless of where one comes out on each individual point, there is cumulatively, strikingly clearly an impermissibly misleading non-neutral POV. Following is the original text with my additions in brackets:

“Ivermectin has been championed by a number of social media influencers.” I also struck out “social media influencers.”

American podcaster and author Bret Weinstein took ivermectin during a livestream video and said both he and his wife Heather Heying had not been vaccinated because of their fears concerning COVID-19 vaccines. In response, YouTube demonetized the channel.” I struck out “fears concerning.”

In the United Kingdom, retired nurse educator and YouTuber John Campbell has posted videos carrying false claims about the use of ivermectin in Japan as a possible cause of a "miracle" decline in cases.”

This was reverted by @Alexbrns with the note that it was “fringe puffery.”

I wasn’t puffing them up, merely partly restoring a neutral POV. They are painted as social media influencers with no relevant training or experience (other than Campbell as a nurse educator). It is essential that the fact that Campbell has a PhD and that Weinstein and Heying are biologists is made clear as that shows they have the training to analyze studies, and that “fears” about the vaccines are changed to “concerns about.”

I would also change the text calling them “social media influencers,” as I did in my edit and also the very arguably NNPOV headings (which I did not edit). I am willing to let these issues above in this paragraph go but there HAS to be some at least compromise change to make the bias and NNPOV less egregious. I am reverting back to my edits of “biologist” for Weinstein and Heying and “PhD” for Campbell. Please let’s discuss here before any reversions or edits. JustinReilly (talk) 19:14, 10 May 2022 (UTC)

Also reverting “fears” to “concerns.” JustinReilly (talk) 19:15, 10 May 2022 (UTC)

Please do not use Misplaced Pages to push fringe agendas. Nobody calls misinformation merchants "science youtubers" (except perhaps other misinformation merchants). Trying to highlight the prior careers of such people is also a WP:PROFRINGE gambit. Alexbrn (talk) 19:24, 10 May 2022 (UTC)

If countries and states promote the use of Ivermectin how can the topic simply be dismissed as a fringe agenda? You posit that entire countries are irrelevant when you leave out alternate viewpoints in a contentious issue as if there were none.

Hubris is a funny thing, few realise until the fall.

If the state of Tennessee in the USA makes Ivermectin available over the counter due to genuine demand and lack of harm how can anyone call it fringe with a straight face. Call it out for what it is, anti narrative, and then be ready to support it when it becomes part of the narrative because the data will no longer change, the narrative will. Both House and Senate voted over 70% in favour, are they all fringe?

One of the sister sites (ivmstatus) of that 'evil' one mentioned above has simply collected facts, kind of like Misplaced Pages and done a basic calculation showing that over 25% of the world uses Ivermectin to manage covid-19. Calling that fringe is laughable yet editors on Misplaced Pages are smug about it when they do so when I read the comment above, emotive gloating words like misinformation merchants, profringe gambits, for shame, what agenda are you trying to promote because it is not facts? Why accuse someone of pushing a fringe agenda when you are propping up a false narrative that is not supported by facts?

Also see if you can find many mentions in the mainstream media about the Senate Directive SA0620, it should be shouted out by all the Horse Paste news channels to say at least in TN you can get the human form and the Horse Paste is no longer needed but maybe it is just too much facts that are better kept quiet. The anti-Ivermectin lobby is much stronger and more dangerous than the pro-Ivermectin movement and the only reason for the narrative you hold dear. As editors on Misplaced Pages it behoves you to have a balanced view and this Ivermectin4covid page has only negative things to say, it is the height of biased editing and reflects very poorly on the original goals of Misplaced Pages.

Idyllic press (talk) 19:47, 30 May 2022 (UTC)

Just cite some sources that comply with WP:MEDRS and then everyone will be happy. Phil Bridger (talk) 20:06, 30 May 2022 (UTC)

lack of harm

— The Hand That Feeds You: 18:27, 31 May 2022 (UTC)

Neither politicians nor a vaguely-defined "popular demand" are medical experts. If you read the Conspiracy theory article, you can see that health-based psuedoscience has a long history of influencing the policy of governments. StuckEarlier (talk) 21:48, 3 June 2022 (UTC)

These edits by JustinReilly bring this page farther away from NPOV rather than closer to it. If a spade is a spade, we should call it as such, and not dilly dally around weasel words to make people feel that a subjective non-evidence-backed position is sufficiently "respected." It does not matter how many countries' politicians champion this treatment. What matters is what the data in MEDRS say. — Shibbolethink 16:01, 4 June 2022 (UTC)

Semi-protected edit request on 17 May 2022

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In the second paragraph of this section there is a small spelling inconsistency with the American English used in the article. I propose to change the bolded sceptical to its American English spelling skeptical.

Early in the COVID-19 pandemic, laboratory research suggested ivermectin might have a role in preventing or treating COVID-19. Online misinformation campaigns and advocacy boosted the drug's profile among the public. While scientists and physicians largely remained sceptical, some nations adopted ivermectin as part of their pandemic-control efforts. Some people, desperate to use ivermectin without a prescription, took veterinary preparations, which led to shortages of supplies of ivermectin for animal treatment. The FDA responded to this situation by tweeting "You are not a horse" to draw attention to the issue. Samipokanikan (talk) 13:58, 17 May 2022 (UTC)

What makes you think that this article uses American English? It includes the template {{Use Oxford spelling}} near the beginning. Phil Bridger (talk) 14:08, 17 May 2022 (UTC)

I thought seeing words like "organizations" instead of "organisations" suggested so, but yeah, I just saw the template and checked the spelling is consistent with it. Sorry! Samipokanikan (talk) 14:13, 17 May 2022 (UTC)

References

1. Cite error: The named reference Caly2020 was invoked but never defined (see the help page).
2. Cite error: The named reference shortage was invoked but never defined (see the help page).

Semi-protected edit request on 17 May 2022 (2)

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typo: sceptical -> skeptical Ssxdd (talk) 22:45, 17 May 2022 (UTC)

 Not done per section above. Please see MOS:ENGVAR. -- Tamzin (she/they) 22:57, 17 May 2022 (UTC)

Silly joke tweet in the lead

Can we not have memes in the leads of medical articles, please? I removed the line The FDA responded to this situation by tweeting "You are not a horse" to draw attention to the issue, but it was reverted. Endwise (talk) 13:17, 28 July 2022 (UTC)

It's not a "meme", it's what the FDA said in response to people (unwisely) taking horse paste and the consequent rise in poisonings and squeeze on vet supplies. As it's interestingly expressed it also helps draw the reader into the article (as a lede should). Alexbrn (talk) 13:46, 28 July 2022 (UTC)

As it's interestingly expressed it also helps draw the reader into the article (as a lede should) it also helps draw the reader into the article (as a lede should) -- A Misplaced Pages lead should specifically not "tease people into reading further" (see MOS:NOTLEDE). The tweet itself is a joking PSA that went viral because it's funny, and subsequently became a meme. The lead already mentions that people were taking veterinary ivermectin products. The only thing the tweet adds is its humour value, which is not the kind of thing we should be including in a summary of the most important contents of a medical article. Endwise (talk) 14:00, 28 July 2022 (UTC)

Oh it's not a "tease" but it does cultivate interest in reading on. I don't think it's funny people were taking horse paste and dying as result; it's interesting a weighty body like the FDA messaged in this way however. Alexbrn (talk) 14:13, 28 July 2022 (UTC)

I think this tweet is a notable event in this saga, and thus deserves inclusion. — Shibbolethink 15:15, 29 July 2022 (UTC)

Yes, and this article is in large part about the lunacy/quackery that swept though parts of the world, and the response to that. It's not really a dry medical topic. Ben Garrison's ivermectin cartoon is also kind of iconic I wish we could use it somehow. Alexbrn (talk) 15:30, 29 July 2022 (UTC)

I would totally include that with a caption like: "During the early pandemic, pro-ivermectin fervor was often placed in opposition to Anthony Fauci and Allopathic medicine in general." I would put it in Scientists targeted or Regulatory status and off-label use. is it open for our use, copyright-wise though? — Shibbolethink 15:38, 29 July 2022 (UTC)

I'm quite uncomfortable with the tweet. First of all, I don't need to explain that tweets fail WP:MEDRS and as such should never be quoted in support of any medical opinion. Two, the lead section should offer a WP:WORLDWIDE view on the subject matter wherever possible. Yes I understand that a large proportion of our editors live in the US, but let's don't forget that the US is still barely 5% of the world's population, and the local US squabbles or agencies are of little relevance to the remaining 95%.

A rough comparison: As a non-US person, I frankly wouldn't care what, say, the FAA would tweet to its followers about Boeing 737 MAX – because FAA's (flawed) approval process (fortunately) does not apply where I live and my national aviation agency issues type approvals independently. So, while a mention of the formal FAA certification process in the lead of Boeing 737 MAX groundings would be fine, dedicating a whole sentence to a FAA tweet would certainly be undue. — kashmīrī  15:58, 29 July 2022 (UTC)

Strangely the tweet is WP:MEDRS as it embodies the position of a major medical organization (not that the statement that people are not horses is a particularly controversial biomedical assertion in need of weighty sourcing!). I'm not a Yank either, but cannot help but observe that the USA has been the locus of most of the ivermectin lunacy. It is what it is. Alexbrn (talk) 16:06, 29 July 2022 (UTC)

No, a tweet is NOT MEDRS, however you try to tweak WP:MEDRS. This lunacy was prevalent everywhere; it's just we mostly rely on English-language media (a known WP bias). — kashmīrī  16:09, 29 July 2022 (UTC)

Thirdly, this tweet does look incredibly silly, even idiotic, given that a fair number of veterinary medications have been repurposed for human use. WP should offer unbiased knowledge and not advocacy, even if for a noble cause. — kashmīrī  15:58, 29 July 2022 (UTC)

Sounds like fringey special pleading. Eating horse paste is not drug "repurposing"; hence the FDA tweet! Alexbrn (talk) 16:15, 29 July 2022 (UTC)

You are not a horse suggests that veterinary medications in general should not be used in humans; which is untrue. — kashmīrī  17:30, 29 July 2022 (UTC)

What rubbish. If you want to write about how it's good to take veterinary preparations, write a blog post or something - but don't try to influence Misplaced Pages with this nonsense. Alexbrn (talk) 17:43, 29 July 2022 (UTC)

Did I write so? No? So why are you manipulating my words? I suggest you retract this personal "remark". — kashmīrī  18:12, 29 July 2022 (UTC)

If you want to assert that the FDA is "idiotic" for wanting to stop people taking animal medicine, Misplaced Pages probably isn't the place for you. Alexbrn (talk) 18:20, 29 July 2022 (UTC)

If you are unable to understand written word, perhaps you should rethink your participation, too. Now point me to where I wrote that the FDA is idiotic. Let me remind you that casting aspersions is a form of personal attack, and you're doing it for the third time in this thread. — kashmīrī  18:54, 29 July 2022 (UTC)

"this tweet does look incredibly silly, even idiotic" ← and enough of the sealioning. You've been around long enough to be better than that. Alexbrn (talk) 19:00, 29 July 2022 (UTC)

(1) Where did I term the FDA as idiotic as you claim? (2) Where did I write that it's good to take veterinary preparations as you claim? You'd rather present evidence or retract your absurd accusations. You've been around not much shorter than me to know there are lines that should not be crossed in a discussion. — kashmīrī  01:05, 30 July 2022 (UTC)

Neither of you, as far as I can ascertain, have crossed any lines that should not be crossed in a discussion. Let's refrain from derailing this discussion into special pleading, ad hominem, or tone policing. — Shibbolethink 12:49, 30 July 2022 (UTC)

The mistake here is conflating ivermectin horse treatments with human ivermectin treatments. The tweet is relevant because people were using the large animal dosage veterinary treatment, which is completely unsafe. It's not even a veterinary medicine "repurposed" for human use, it's two different dosages, which makes it inappropriate for human consumption. Not to mention ivermectin was never effective at treating COVID-19, so warning people off using the veterinarian medication is relevant. — The Hand That Feeds You: 16:42, 29 July 2022 (UTC)

Exactly, this is the whole point of this aspect of the topic. Alexbrn (talk) 16:46, 29 July 2022 (UTC)

Once again: a quote from a FDA drug review stating that ivermectin is ineffective and unsafe in such doses would be absolutely fine and helpful. A tweet saying "You are not a horse" is idiotic for all the reasons I stated above, and also in violation of MEDRS. — kashmīrī  17:27, 29 July 2022 (UTC)

"also in violation of MEDRS" - MEDRS is irrelevant here. — Shibbolethink 13:23, 30 July 2022 (UTC)

Oh, just because you say so? — kashmīrī  21:07, 31 July 2022 (UTC)

I agree with Shibboble that MEDRS isn't an issue here. The tweet basically just says that human beings aren't horses; I don't think that's the kind of biomedical information you need a MEDRS-compliant source for. It's so trivially true that humans aren't horses as to be humorous, because the tweet was a joke. Endwise (talk) 02:48, 31 July 2022 (UTC)

I'll third this: it's a WP:SKYBLUE statement by the FDA that humans shouldn't be taking horse-dosed medication. MEDRS isn't necessary. — The Hand That Feeds You: 16:53, 31 July 2022 (UTC)

I think it's worth keeping the tweet and comment about horse medicine being used. However, the lead could also benefit by including that the FDA warned against treating or preventing COVID-19 with ivermectin. An archived page says March 5, 2021. I'm not sure if there's an earlier statement to refer to. ScienceFlyer (talk) 21:25, 1 August 2022 (UTC)

Yknow what's interesting? We don't have to rely on editor opinions alone to determine whether or not this tweet is worth including. We have guidelines such as WP:DUE and essays such as WP:RSUW. This tweet is noteworthy enough to be referenced in many multiple high quality RSes (also outside the US and even scholarly publications , therefore it has DUE weight and should be included. If the NYT, NPR, WaPo, Guardian, El Pais, and scholars all think this is noteworthy, who are we to disagree?— Shibbolethink 13:20, 30 July 2022 (UTC)

MEDRS still applies to this article. In addition we also have:

• MOS:LEAD which requires that the lead section should be a summary of most important contents – and we see nothing that the "horse tweet" could be a summary of;
• WP:NOTGUIDE, i.e., articles should not aim to influence the reader's behaviour (and instead offer objective knowledge) – whereas it seems that some editors here believe they are running a public health campaign.

That tweet in the lead fails on so many fronts that I can't believe my eyes that some editors still keep pushing it in. Is it because ivermectin use has become a political statement in the United States, or what? — kashmīrī  21:07, 31 July 2022 (UTC)

I'll remind you of WP:NPA, comments like some editors here believe they are running a public health campaign is not assuming good faith. — The Hand That Feeds You: 21:14, 31 July 2022 (UTC)

Oh, public health campaigns are mostly run in good faith. Besides, pointing out to our WP:NOT policy is not against WP:AGF. — kashmīrī  22:28, 31 July 2022 (UTC)

That's clearly not what you were implying, but whatever. The discussion has petered out with no consensus in support of your change. — The Hand That Feeds You: 22:36, 31 July 2022 (UTC)

I would actually agree with WP:AGF being applicable here for @Kashmiri. In reference to this statement they made: That tweet in the lead fails on so many fronts that I can't believe my eyes that some editors still keep pushing it in. Is it because ivermectin use has become a political statement in the United States, or what?Proposing that everyone else (especially those who disagree with you) is pushing a political agenda is the exact opposite of WP:AGF. — Shibbolethink 22:55, 31 July 2022 (UTC)

Not "pushing a political agenda", but making a political statement. Certainly, not a medical or scientific statement. Ivermectin use for COVID-19 is a minor public health problem compared to, for instance, the widespread antibiotic use for minor viral infections (which is incorrect, obviously, and can lead to severe complications). Yet I don't see a separate article dedicated to the topic, complete with tweets in the lead. Not even a single tweet in antibiotic. Why? Why ivermectin has apparently become a cause worth dying for some? Or at least worth flouting so many Misplaced Pages policies? — kashmīrī  23:39, 31 July 2022 (UTC)

The FDA don't think it's "a minor public health problem", which is kind of the point (ivermectin taken as an alternative to vaccination is kind of serious). If you think Antimicrobial resistance#Clinical misuse could be worked up into a standalone article (and maybe it could) then do that, but it's not relevant to what we have here. What we do have is fine, and consensus seems firm on that point. Time to drop the WP:STICK methinks. Alexbrn (talk) 05:58, 1 August 2022 (UTC)

compared to, for instance, the widespread antibiotic use for minor viral infections (which is incorrect, obviously, and can lead to severe complications). Yet I don't see a separate article dedicated to the topic.... yknow there actually is an article which pretty closely covers that topic: Antibiotic misuse. If the FDA put out a joke tweet about it...and it was covered by many multiple reputable and trustworthy RSes (including scholarly ones and non-US ones)... Then I think it would pretty clearly deserve inclusion in that article. if you hear about such a tweet, let me know and I'll add it myself. — Shibbolethink 07:09, 1 August 2022 (UTC)

(In fact they put out a poster in 2009(?) I guess they're just moving with the times and adopting informal comms via social media for their public health messaging. All great stuff worthy of coverage as the sourcing indicates.) Alexbrn (talk) 07:47, 1 August 2022 (UTC)

• I don't really mind seeing this tweet in here; it demonstrates the authorities' willingness to conflate mechanism and dosage, and therefore unintentionally informs the reader of the cavalier and un-academic approach by the FDA on this matter. (If I contract giardia and take metronidazole, does that make me a dog?) SmolBrane (talk) 20:42, 1 August 2022 (UTC)

  Well important to say that Flagyl (AKA metro) is off-label in such uses for dogs. Whereas, with ivermectin, it's on-label for horses in the paste form, and off-label for us humans. So it's actually kind of the inverse. And if you take it 1-2 hours before a full moon, you'll have to tell us what happens cuz I've never actually seen it, only heard the rumors. — Shibbolethink 20:44, 1 August 2022 (UTC)

  That's exactly what's unwelcome: ridicule. This was a valid medical question: whether ivermectin could be repurposed, or at least effectively used off label, like hundreds of other medications are routinely used off label with good effects (read Off-label use#Frequency of off-label use). Some clinical studies showed ivermectin was effective for COVID19, others showed it wasn't. Meta-analyses were carried out and showed it was not effective based on existing evidence. That's it, end of story – there's lack of strong evidence to support such a use of ivermectin. Slogans like "You are not a horse" are out of place in a medical article, as are your words about full moon, etc. Focus on facts, not on ridiculing; it's science, not petty politics. — kashmīrī  04:16, 2 August 2022 (UTC)

  I don't think you understand "the story" is you think it was the dry sequence you describe, or that this is purely "a medical article". Alexbrn (talk) 05:09, 2 August 2022 (UTC)

  Pretty much agreeing with kashmiri here, ivermectin was taken as a speculative treatment given its extraordinary safety record, generic status and plausible value as a protease inhibitor, not because people thought they were horses. But the FDA doesn't do a great job with speculative utility, as illustrated here, and as we can tell by the poor efficacy of the vaccines that were emergency-approved by this organization. The issue is deeper though, wiki defers to sources and the established reliable sources are not so sympathetic to the speculative use of ivermectin. Readers have deductive skills, luckily. SmolBrane (talk) 16:24, 4 August 2022 (UTC)

  FDA wasn't saying people were horses, but that they shouldn't take horse medicine (formulated for 2 tonne animals!). People took it because they were conned by the cranks, frauds and grifters pushing this stuff. As to your antivax rant - much more of that and you can expect to be removed from the Project. Alexbrn (talk) 16:29, 4 August 2022 (UTC)

  No, the FDA was reminding people that they were not horses, which actually has no relevance to the issue at hand, as I stated. As for your last sentence, please AGF and refrain from threats. (And shibb, metronidazole is not off-label for dogs.) SmolBrane (talk) 16:35, 4 August 2022 (UTC)

  You: "shibb, metronidazole is not off-label for dogs."The reliable sources:
  "Metronidazole is not approved for use in dogs in the U.S." "Veterinarians use metronidazole as an off-label medication since it is not FDA-approved for dogs" "Metronidazole is not approved for use in dogs in the U.S." @SmolBrane, what expertise do you have again? Remember, I'm a microbiologist. — Shibbolethink 23:29, 4 August 2022 (UTC)

  @Alexbrn, I strongly suggest you to consider stopping personal attacks. If you continue with your groundless allegations (that I promote "fringey theories" or that SmolBrane is an antivaxxer), you will be dragged to ANI, quickly.

  If you want to educate yourself about the existing COVID-19 vaccines, there are plenty of systematic reviews which – to save you reading – demonstrate that virtually all the existing COVID-19 vaccines are significantly less effective than any other vaccine commonly used in routine immunisation programmes. The efficacy against the omicron variant is even smaller.. Now compare it to, say, the efficacy of the polio vaccine. Will it be too much to expect you to walk back your attack on SmolBrane? — kashmīrī  22:32, 4 August 2022 (UTC)

  The vaccines were 94+% effective when first formulated . Is our memory really that short?Also, that Lancet paper doesn't show what you think it does. It demonstrates really good protection and longevity of vaccine efficacy in preventing hospitalization (what the vaccines were actually intended to do) for 4+ months (the longest period they studied) against BA.1. We in the vaccine community always expected BA.2, BA.5 etc would require reformulated vaccines, based on their spike protein sequences. Hence why such vaccines are almost done with post-phase 3 approval in the US and will likely be on store shelves by the fall.The systematic reviews you linked also do not show what you claim. Three mRNA doses appear to be "96%" effective" against documented COVID-19 infection, according to Table 2 Always a bad idea to try and out-science a scientist (me) in their field of expertise. Alexbrn, while not classically trained, is probably the most well-read on the topic of COVID-19 treatment and prevention of anyone I've met on this site. — Shibbolethink 23:34, 4 August 2022 (UTC)

  I don't know about vaccine science, but I do know antivax rhetoric (and pompous apology for it) when I see it. I also know this is WP:NOTAFORUM and think this thread should be closed as any prospect of it leading to article improvements seems past. Alexbrn (talk) 01:10, 5 August 2022 (UTC)

References

1. Sultana, Tania; Jan, Umair; Lee, Jeong Ik (2022-04-13). "Double Repositioning: Veterinary Antiparasitic to Human Anticancer". International Journal of Molecular Sciences. 23 (8): 4315. doi:10.3390/ijms23084315. ISSN 1422-0067. PMC 9029030. PMID 35457127.{{cite journal}}: CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
2. AbdelKhalek, Ahmed; Seleem, Mohamed N. (2020). "Repurposing the Veterinary Antiprotozoal Drug Ronidazole for the Treatment of Clostridioides difficile Infection". International Journal of Antimicrobial Agents. 56 (6): 106188. doi:10.1016/j.ijantimicag.2020.106188. PMC 7704610. PMID 33045352.{{cite journal}}: CS1 maint: PMC format (link)
3. Miglianico, Marie; Eldering, Maarten; Slater, Hannah; Ferguson, Neil; Ambrose, Pauline; Lees, Rosemary S.; Koolen, Karin M. J.; Pruzinova, Katerina; Jancarova, Magdalena; Volf, Petr; Koenraadt, Constantianus J. M. (2018-07-17). "Repurposing isoxazoline veterinary drugs for control of vector-borne human diseases". Proceedings of the National Academy of Sciences. 115 (29). doi:10.1073/pnas.1801338115. ISSN 0027-8424. PMC 6055183. PMID 29967151.{{cite journal}}: CS1 maint: PMC format (link)

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