Connor Harris explains in his City Journal article Try a Dose of Skepticism. Excerpts in italics with my bolds.
Ivermectin may or may not work against Covid-19, but media coverage of the drug has been sneering, inaccurate—and revealing.
“You are not a horse. You are not a cow. Seriously, y’all. Stop it,” read a recent viral tweet warning readers away from using a certain medication to treat Covid-19. The tone of affectedly folksy condescension would be expected from any of thousands of Twitter-addicted progressive journalists, but less so from the official account of the United States Food and Drug Administration. Perhaps even more surprising, the tweet linked to a warning advising readers not to take a drug, ivermectin, that has been used in humans for decades and is a standard Covid-19 treatment in much of the world.
The media’s recent reporting on ivermectin is a fitting sequel to their reporting on hydroxychloroquine near the beginning of the pandemic—but not, as received opinion would have it, because both are tales of red-state yokels duped into taking poisonous phony remedies. As in the earlier case, media coverage of ivermectin exemplifies how the liberal political class’s bias, and its confusion of respect for science with blind trust in a scientific establishment, impairs their skepticism and their capacity to appraise complex scientific questions.
Ivermectin is one of several derivatives of a family of compounds first isolated in the 1970s from soil bacteria in Japan. The compounds are highly toxic to invertebrates but have few effects on mammals, making them excellent treatments for many diseases caused by parasitic worms. Though ivermectin is more commonly used in livestock in First World nations where human parasites are rare, it is widely given to humans for internal use elsewhere. Distribution of ivermectin in tropical Africa has virtually eliminated diseases such as river blindness, a success that won the drug’s discoverers a share of the Nobel Prize in Medicine in 2015.
Ivermectin, then, has long been used in humans—and it is entirely reasonable to think that it could be effective against Covid-19.
It may be surprising that an antiparasitic medication might work against viruses, but such surprises are common in medicine: as another example, the psychotropic drug fluvoxamine, used to treat OCD and depression, has shown positive results against Covid-19 in multiple trials, including one large international collaboration. Ivermectin was shown to have antiviral effects in laboratory settings in 2012, when one study found that it protected cell cultures from infection by flaviviruses, which include the viruses that cause yellow fever and dengue. Interest in ivermectin as a Covid-19 treatment was sparked by a study at Monash University in Australia, which found that the drug could virtually eliminate SARS-CoV-2 from cell cultures within two days, albeit at very high concentrations.
Studies in cell cultures, though, can establish only that a drug might work; to decide that it does work requires human studies. The evidence base in this regard is ultimately inconclusive but suggests that ivermectin could provide a meaningful benefit.
Media attention to ivermectin is largely thanks to a group of doctors who call themselves the Frontline Covid-19 Critical Care Alliance. Pierre Kory, one of FLCCC’s founders, has advocated ivermectin treatment in several high-profile public appearances, including testimony before the Senate Homeland Security Committee last December and a more recent interview in June on the popular podcast DarkHorse, hosted by Bret Weinstein and Heather Heying. FLCCC puts out continually revised protocols that include ivermectin as a main component, as well as other drugs with varying degrees of empirical support.
FLCCC’s exact protocols have never been tested in randomized trials, but there are some weaker forms of evidence in their favor; many other doctors who use FLCCC or similar protocols have claimed vast improvement over typical rates of death and hospitalization. Overseas, influential doctors such as the chairman of the Tokyo Metropolitan Medical Association have called for widespread ivermectin use, and the drug is a standard treatment in much of Latin America, among other areas.
Still, given the drug’s relatively low risk profile, it may be reasonable to try ivermectin against Covid-19 despite the ambiguous evidence of benefits. And in any case, the sneering descriptions of the drug as an assuredly useless livestock de-wormer and the wild exaggerations of its dangers—both close parallels with the news coverage of hydroxychloroquine in spring 2020—cannot be justified.
Liberals have no monopoly on gullibility or lazy journalism, but the biased coverage of ivermectin springs from one of the worst pathologies of liberal discourse in particular: conflation of respect for science with fealty to established scientific institutions. A “pro-science” disposition has long been integral to American liberals’ self-conception (a ubiquitous yard sign reads, in part, “In this house, we believe science is real”); it grew especially strong during the George W. Bush years as a reaction to the administration’s stance on global warming and alliance with the religious Right.
But most Americans are scientists neither by training nor by temperament, and “pro-science” politics usually calcifies into blind trust in a few politically congenial authorities—such as universities and government health agencies, which have enjoyed high levels of liberal confidence throughout the pandemic despite such actions as reversing longstanding advice on face masks based on a dubious judgment call.
Conflating science with the scientific establishment not only corrodes the capacity for skepticism but also helps questionable or corrupt actions by authorities escape scrutiny. The hullabaloo over ivermectin poisoning, for example, far exceeds the attention given to another questionable treatment pushed not by right-wing hucksters but by the FDA itself: remdesivir, an antiviral produced by the pharmaceutical giant Gilead Sciences that is still the only Covid-19 treatment with full FDA approval.
The FDA’s approval of remdesivir in October 2020 was based on only three trials, one neutral and two showing only moderate shortenings of hospital stays. A week before the approval, a far larger trial sponsored by the WHO had found that remdesivir did not reduce mortality, leading the WHO to advise against the drug in November. (The New York Times report on the WHO trial, incidentally, gave ample space to a fair presentation of criticism of the trial from defenders of remdesivir, a marked difference from the tone of most recent ivermectin coverage.) Furthermore, remdesivir seems to cause significant harms to the kidneys in many cases: a “disproportionality analysis” of VigiBase, for instance, found that reports for remdesivir were 20 times as likely to mention kidney failure as reports for other Covid-19 drugs.
The FDA’s full approval of remdesivir contrasted with its summary dismissal of ivermectin suggests, at the least, a double standard.
The oddity of the FDA’s remdesivir approval received some mainstream coverage, but it came nowhere near the level of media saturation reached by the reports of Mississippians taking horse de-wormer. It’s not hard to understand why: the horse de-wormer stories gave some readers a delicious opportunity to feel smugly superior to their political enemies—a temptation that few of us find easy to resist. But the tale of remdesivir presents a more threatening specter, which journalists and politics junkies would do well to confront: the possibility that a scientific authority might be wrong.