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From early on into the pandemic, I have received unsolicited advise about ivermectin and #COVID.
e.g. "I would like to add to your thinking before you start your trial"
Others ask why am I "opposed" to ivermectin? (spoiler alert
I am NOT)
THREAD
https://www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/questions-and-answers-about-ivermectin-and-covid-19/2877257/0
e.g. "I would like to add to your thinking before you start your trial"
Others ask why am I "opposed" to ivermectin? (spoiler alert
I am NOT)THREAD https://www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/questions-and-answers-about-ivermectin-and-covid-19/2877257/0
2/16
I have been working with ivermectin since 2008. This includes animal models, insectary work and clinical trials.
Here is one of my earliest experiences with it. A girl with disseminate strongyloides in rural Venezuela.
Ivermectin saved her live.
https://www.nejm.org/doi/full/10.1056/NEJMc1210168
I have been working with ivermectin since 2008. This includes animal models, insectary work and clinical trials.
Here is one of my earliest experiences with it. A girl with disseminate strongyloides in rural Venezuela.
Ivermectin saved her live.
https://www.nejm.org/doi/full/10.1056/NEJMc1210168
3/16
My main interest in #ivermectin has been its capacity to kill malaria vectors. This could reduce transmission. A new way to fight malaria.
In 2008, with help from @CMO_England, I conducted the first clinical trial to prove the concept:
https://academic.oup.com/jid/article/202/1/113/888773
My main interest in #ivermectin has been its capacity to kill malaria vectors. This could reduce transmission. A new way to fight malaria.
In 2008, with help from @CMO_England, I conducted the first clinical trial to prove the concept:
https://academic.oup.com/jid/article/202/1/113/888773
4/16
But it turns out we needed to convince a LOT of people of the potential value of this approach.
Drug people would say "go talk to mosquito people" and mosquito people would say "go talk to drug people".
(In Spain we say "the fish that bites its own tail")
But it turns out we needed to convince a LOT of people of the potential value of this approach.
Drug people would say "go talk to mosquito people" and mosquito people would say "go talk to drug people".
(In Spain we say "the fish that bites its own tail")
5/16
Finally in 2016 the @WHO held a technical consultation (in which I was honored to participate) that resulted on clear guidance: https://www.who.int/malaria/mpac/mpac-sept2016-invermectin-session9.pdf?ua=1
See also our @gatesfoundation funded roadmap here: http://www.ajtmh.org/content/journals/10.4269/ajtmh.19-0620
Finally in 2016 the @WHO held a technical consultation (in which I was honored to participate) that resulted on clear guidance: https://www.who.int/malaria/mpac/mpac-sept2016-invermectin-session9.pdf?ua=1
See also our @gatesfoundation funded roadmap here: http://www.ajtmh.org/content/journals/10.4269/ajtmh.19-0620
6/16
This process has opened the door to a lot of important research on ivermectin and #malaria. There are now several groups conducting field trials. Our own project is called BOHEMIA and it has been funded by @UNITAID https://bohemiaconsortium.org/
This process has opened the door to a lot of important research on ivermectin and #malaria. There are now several groups conducting field trials. Our own project is called BOHEMIA and it has been funded by @UNITAID https://bohemiaconsortium.org/
7/16
Then along came #COVID.
Ivermectin DOES indeed inhibit the replication of #SARSCoV2 in vitro.
I wrote a long thread (full of typos) about that here: https://twitter.com/carlos_chaccour/status/1246432970669465600?s=20
Then along came #COVID.
Ivermectin DOES indeed inhibit the replication of #SARSCoV2 in vitro.
I wrote a long thread (full of typos) about that here: https://twitter.com/carlos_chaccour/status/1246432970669465600?s=20
8/16
There, I clearly laid out the reasons for hope (i.e. please refrain from your patronizing advise on why it will NOT work).
Answers here: https://www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/questions-and-answers-about-ivermectin-and-covid-19/2877257/0#why
But I also called for rigor and having supporting efficacy and safety data (in COVID px) before widespread use.
There, I clearly laid out the reasons for hope (i.e. please refrain from your patronizing advise on why it will NOT work).
Answers here: https://www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/questions-and-answers-about-ivermectin-and-covid-19/2877257/0#why
But I also called for rigor and having supporting efficacy and safety data (in COVID px) before widespread use.
9/16
Those arguments were published in a guest editorial at @AJTMH :
http://www.ajtmh.org/content/journals/10.4269/ajtmh.20-0271
Those arguments were published in a guest editorial at @AJTMH :
http://www.ajtmh.org/content/journals/10.4269/ajtmh.20-0271
10/16
But why wait? this is safe, there are people dying!
Indeed, we should all have a rightful sense of urgency. This can lead to cutting some corners but by no means ALL corners.
Answer here: https://www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/questions-and-answers-about-ivermectin-and-covid-19/2877257/0#whynot
But why wait? this is safe, there are people dying!
Indeed, we should all have a rightful sense of urgency. This can lead to cutting some corners but by no means ALL corners.
Answer here: https://www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/questions-and-answers-about-ivermectin-and-covid-19/2877257/0#whynot
11/16
Also, please know that many fell for the misleading preprints on ivermectin and COVID-19 linked to the #LancetGate scandal and what seems to be a fraudulent database.
More on that subject here: https://www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/ivermectin-and-covid-19-how-a-flawed-database-shaped-the-covid-19-response-of-several-latin-american-countries/2877257/0
Also, please know that many fell for the misleading preprints on ivermectin and COVID-19 linked to the #LancetGate scandal and what seems to be a fraudulent database.
More on that subject here: https://www.isglobal.org/en/healthisglobal/-/custom-blog-portlet/ivermectin-and-covid-19-how-a-flawed-database-shaped-the-covid-19-response-of-several-latin-american-countries/2877257/0
12/16
So where are we now? what about your trial?
SAINT was launched in May, during the lockdown in Spain. At that stage we spent several weeks with 10 or less COVID diagnosis in Navarra.
Sadly, cases are surging again. So we are now recruiting fast. http://saintproject.org/
So where are we now? what about your trial?
SAINT was launched in May, during the lockdown in Spain. At that stage we spent several weeks with 10 or less COVID diagnosis in Navarra.
Sadly, cases are surging again. So we are now recruiting fast. http://saintproject.org/
13/16
When will you have results?
There is no fixed date. The trial will finish four weeks after the last recruitment as stated in the protocol. https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-020-04421-z
When will you have results?
There is no fixed date. The trial will finish four weeks after the last recruitment as stated in the protocol. https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-020-04421-z
14/16
What else are you doing?
SAINT will be replicated in Lima - Peru.
We have partnered with @CayetanoHeredia to conduct an independent trials using an adaptation of the SAINT protocol there.
What else are you doing?
SAINT will be replicated in Lima - Peru.
We have partnered with @CayetanoHeredia to conduct an independent trials using an adaptation of the SAINT protocol there.
15/16
Wait so are you pro or against ivermectin?
I am pro science and pro evidence.
I wish as much as anyone that we find a cheap and broadly available cure for this disease as soon as possible.
But primum non nocere.
We do not need another HQ fiasco.
Wait so are you pro or against ivermectin?
I am pro science and pro evidence.
I wish as much as anyone that we find a cheap and broadly available cure for this disease as soon as possible.
But primum non nocere.
We do not need another HQ fiasco.
16/16
Ivermectin is my line of work. I know it very well and I wished it works against COVID.
But evidence comes before policy and we need at the very least one robust, large, randomized, placebo-controlled double-blinded, clinical trial before jumping to advocacy.
Ivermectin is my line of work. I know it very well and I wished it works against COVID.
But evidence comes before policy and we need at the very least one robust, large, randomized, placebo-controlled double-blinded, clinical trial before jumping to advocacy.
