Ivermectin is an antiparasitic drug, and a very good one. If you are infected with the roundworms that cause river blindness or the parasitic mites that cause scabies, it is wonderfully effective. It is cheap; it is accessible; and its discoverers won the Nobel Prize in 2015. It has also been widely promoted as a coronavirus prophylactic and treatment.This promotion has been broadly criticized as a fever dream conceived in the memetic bowels of the internet and as a convenient buttress for bad arguments against vaccination. This is not entirely fair. Perhaps 70 to 100 studies have been conducted on the use of ivermectin for treating or preventing COVID-19; several dozen of them support the hypothesis that the drug is a plague mitigant. Two meta-analyses, which looked at data aggregated across subsets of these studies, concluded that the drug has value in the fight against the pandemic.
So if you’re the sort of person who “follows the science,” it might seem perfectly rational to join the fervent supporters of ivermectin. It might even strike you as reasonable to suggest, as one physician and congressional witness did recently, that “people are dying because they don’t know about this medicine.”The problem is, not all science is worth following.
I work on a small team of researchers who do what one might call “forensic peer review.” In the standard process for scientific publishing, peer reviewers take a manuscript mostly at face value: They ensure that the study makes sense as it’s described. We do something else: We check everything, and try to ferret out any potential biases in reported patterns of digits, statistical impossibilities, inconsistencies between what researchers said they’d do and what they actually did, and plagiarized sentences or paragraphs. And we often find fatal flaws hidden behind a veil of two-dollar words and statistical jargon.The ivermectin literature has been no exception. Over the past six months, we’ve examined about 30 studies of the drug’s use for treating or preventing COVID-19, focusing on randomized studies, or nonrandomized ones that have been influential, with at least 100 participants. We’ve reached out directly to the authors of these studies to discuss our findings, sometimes engaging in lengthy back-and-forths; when appropriate, we’ve sent messages to the journals in which studies have been published. In our opinion, a bare minimum of five ivermectin papers are either misconceived, inaccurate, or otherwise based on studies that cannot exist as described. One study has already been withdrawn on the basis of our work; the other four very much should be.In the withdrawn study, a team in Egypt compared outcomes among COVID-19 patients who did and did not receive ivermectin—but, for the latter group, they included deaths that had occurred before the study began. (According to the journal Nature, the lead author “defended the paper” in an email, and claimed that the withdrawal took place without his knowledge. He did not respond to an inquiry from The Atlantic.) Other papers also have egregious flaws. Researchers in Argentina said they recruited participants from hospitals that had no record of having participated in the research, and then blamed mistakes on a statistician who claimed never to have been consulted. A few studies show clear evidence of severe data irregularities. In one from Lebanon, for example, the same section of patient records repeats over and over again in the data set, as if it had been copied and pasted. (An author on that paper conceded that the data were flawed, and claimed to have requested a retraction.)
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