"No conspiracy to keep ivermectin out of Guernsey"

Tuesday 13 July 2021

Guernsey's Medical Director "would be delighted" if Oxford trials found ivermectin to be an effective treatment option against Covid-19, as an Emergency Department Doctor calls for the drug to be made available.

Associate Specialist Dr Scott Mitchell is the co-author of a systematic review that has been published in the American Journal of Therapeutics July/August edition.

Dr Mitchell has contacted senior leaders in health and has written to deputies calling for ivermectin as a treatment option.

Guernsey's Medical Director Dr Peter Rabey said there is currently no evidential proof that ivermectin reduces hospitalisation or illness in Covid-19 patients. 

All eyes are on scientists at the University of Oxford's PRINCIPLE programme, who have initiated trials to find out if the drug can speed up recovery, reduce the severity of symptoms and prevent the need for hospital admission.

The study has so far recruited more than 5,000 volunteers from across the UK. The University of Oxford states that "ivermectin is a safe, broad spectrum anti-parasitic drug which is in wide use globally to treat parasitic infections."

"Small pilot studies show that early administration with ivermectin can reduce viral load and the duration of symptoms in some patients with mild Covid-19."

Video: Dr Peter Rabey commented on ivermectin at the latest press briefing, between 20:30 and 21:20.

Ivermectin has been used in some countries to treat Covid-19 - mainly across Latin America and South Africa. However, PRINCIPLE notes that there is at present "little evidence from large-scale randomised controlled trials" to validate its effectiveness.

The World Health Organisation has declared that current data on the use of ivermectin to treat Covid-19 patients is "inconclusive". Until more data is available, WHO recommends that the drug only be used within clinical trials and not rolled out on a wider scale.

The States is reportedly waiting on the results of the University of Oxford trials before making a decision regarding ivermectin.

Dr Mitchell is an Associate Specialist based at the Emergency Department. He has been calling for ivermectin to be made available. "Tests have shown some benefits to treating patients in hospital with ivermectin," he said. 

"I have been involved with the FLCCC, which is a group of mainly American doctors who have been working on a full systematic review for a number of months. It is a very safe medicine. I think the worst case scenario is that it doesn’t work."

The report he co-authored conducted meta-analysis of 15 trials. It presented "low to moderate certainty" evidence that ivermectin prophylaxis reduced Covid-19 infection by an average of 86% in cases reviewed. It also presented meta-analysis, assessing 2,438 participants, that ivermectin reduced the risk of death by an average of 62% compared with no ivermectin treatment in the cases reviewed. 

Pictured: Clinical trials of the later approved Astra-Zeneca vaccine were carried out by the Oxford University vaccine team.

"The findings indicate with moderate certainty that ivermectin treatment in Covid-19 provides a significant survival benefit. Low-certainty evidence on improvement and deterioration also support a likely clinical benefit of ivermectin," the authors state.

"Low-certainty evidence suggests a significant effect in prophylaxis. Overall, the evidence also suggests that early use of ivermectin may reduce morbidity and mortality from Covid-19."

"The evidence on severe adverse events in this review was graded as low certainty, partly because there were too few events to reach statistical significance."

When asked about ivermectin last month, Guernsey's Medical Director Dr Peter Rabey said: "It's not recommended for use locally and not recommended for use by NICE, but this study that Oxford University is doing on it will be a really high quality study.

"Obviously it is being taken seriously to get that far, so we'll await the results for that and they will tell us one way or the other for sure."

Meanwhile, the World Health Organization, whose recommendations are generally followed by HSC, has advised against the use of ivermectin in its current guidelines on Covid-19 treatments, on the basis of insufficient evidence. 

"A guideline development group was convened in response to the increased international attention on ivermectin as a potential treatment for Covid-19," said the organisation.

Pictured: The WHO has ruled that the current evidence for ivermectin is of "very low certainty" and awaits higher quality trials, which should be provided by the PRINCIPLE team at Oxford.

The WHO said: "The group reviewed pooled data from 16 randomized controlled trials (total enrolled 2407), including both inpatients and outpatients with Covid-19.

"They determined that the evidence on whether ivermectin reduces mortality, need for mechanical ventilation, need for hospital admission and time to clinical improvement in Covid-19 patients is of “very low certainty”, due to the small sizes and methodological limitations of available trial data, including small number of events."

Speaking on the subject again on Friday, Dr Rabey cited the importance of the Oxford study. "If there is good evidence for ivermectin we will be delighted because it is very cheap and it’s easily available and it’s not got many side effects.

"There is no conspiracy to keep ivermectin out of Guernsey. But there’s just no evidence to introduce it yet and we’re keeping a close eye on that."

Pictured top: Guernsey's Medical Director Dr Peter Rabey.