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Comment by prohobo | Hacker News Reader

I don't understand why Japan, India, most of latin america and Brazil are using ivermectin to treat covid then. Are they just hoping for the best?

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They're not using it. Those are Ivermectin conspiracy talking points that are spreading around the internet, but they're either not true or heavily distorted.

Japan is not using Ivermectin. It's a myth that is spreading in the Ivermectin conspiracy circles, but it's not true: https://www.reuters.com/article/factcheck-japan-ivermectinan...

India stopped recommending Ivermectin a long time ago, after not seeing positive results: https://www.thehindu.com/news/national/icmr-stops-use-of-ive...

Brazil's relationship with Ivermectin is mixed at best, but the famed "COVID Kit" that included Ivermectin (among other things) wasn't as official as some try to make it sound: https://www.thelancet.com/journals/lanam/article/PIIS2667-19...

I'm still stunned by how these rumors continue to circulate as facts despite being so easily disproven. On the other hand, some of the top Google results I found while looking those up quickly were obvious conspiracy websites with false information. I suppose the misinformation is just flooding the internet so fast that the truth is getting diluted away.

> Japan is not using Ivermectin.

https://www.nikkei.com/article/DGXZQOFD31A0C0R30C22A1000000/

2022/1/31

興和（名古屋市）は31日、寄生虫病薬「イベルメクチン」が新型コロナウイルスの変異型「オミクロン型」の治療薬として効果があることを確認したと発表した。北里大学との非臨床試験をもとに、抗ウイルス効果があるとした

Bing translation:

"Kowa (Nagoya City) announced today that it has confirmed that the parasitic drug "Ivermectin" is effective as a treatment for the mutant "Omicron type" of the novel coronavirus. Based on the non-clinical trial with Kitasato University, it was said that it had an antiviral effect."

If you dig into that story, it's just a lab result that IVM shows antiviral activity against Omicron. It does not support your implied claim that Japan is actually using IVM.

Here's a source on that I would consider neutral and responsible; when you do a search there are also a number of "fact check" results that pop up: https://www.medpagetoday.com/special-reports/exclusives/9698...

Okay, I'm going to clear up a bit because "they're not using it" is basically a conspiracy theory itself. I think your response doesn't address the question, contradicts itself, and is poorly communicated because of the use of emotional/political buzzwords.

- On August 13th, 2021 The chairman of the Tokyo Medical Association approved the use of ivermectin for covid if a patient gives informed consent and asks to use it. See: https://www.tokyo-np.co.jp/article/123988

So, at least the Tokyo Medical Association in Japan has approved the use of it. Does that mean it's a standard treatment for covid? No, but it does mean that some tens of thousands of doctors in Japan are making it available.

- India stopped using it. That's accurate, and I had no idea this happened because I wasn't following it too closely, but the insinuation is: Well, they clearly were using it. How does that gel with "those are Ivermectin conspiracy talking points" and "I'm still stunned by how these rumors continue to circulate as facts"?

- Brazil, as you concede, is still using ivermectin to treat covid. I agree it's a mixed vibe over there. But again, how does this gel with "they're not using it", "those are Ivermectin conspiracy talking points", and "I'm still stunned by how these rumors continue to circulate as facts"?

- Finally, you forgot about most of latin america, where they continue to use ivermectin. See: https://english.elpais.com/international/2022-02-18/ivermect...

So, can you answer the actual question? I'm not interested in what you think is a conspiracy theory. And well shit, I guess I answered the question myself with that last article I linked; it looks like it's a hedge or hopeful shot in the dark. Imagine all the problems we could avoid if you could just say that?

I've read that ivermectin is fantastic for treating parasite infections. And that these infections co-occuring with covid can make it much harder for your body to deal with covid. And thus in places where parasitic infections are common it can be a very effective treatment. But in places where they are not it doesn't seem to make any difference.

I suppose that the anti-parasitic effect could explain why doctors in South America and Africa are so adamant about it "working".

But the main idea behind ivermectin being used for covid is actually that it's a protease inhibitor. It essentially could directly prevent the virus from replicating.

They found a bunch of repurposable drugs which have that mechanism earlier on in the pandemic, and ivermectin was found to be extremely promising. Researchers just didn't know under what conditions and dosage it would be effective, since during the tests they blasted all of the drugs at maximum potency.

Since then, well... I have no idea. It seems like ivermectin would have to be given in very large doses to actually work, or modified to fix that issue. But instead everyone seems to just be trying to test/use the normal anti-parasitic doses, and I haven't seen anyone trying to modify it to bring out the protease inhibitor effect.

I think the cases in which it works are probably mostly in people with parasites, but there could be some other circumstance that makes it work sporadically - who knows.

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