The Grand Ivermectin Inquisition

Dr Paul Marik

In The Grand Inquisitor, Dostoyevsky’s story within a story in The Brothers Karamazov, Jesus Christ re-appears in Seville in the time of the Inquisition. The common people recognise him immediately as the Son of God, who has returned to cure the sick, raise the dead, and set the people free. When his miracles are made known to the authorities, he is imprisoned and sentenced to death by the Grand Inquisitor, who tells him:

“Everything was given over by Thee to the Pope, and everything now rests with him alone; Thou hast no business to return and thus hinder us in our work.”

Now to the present, from fiction to fact; to the time of pandemic, the year 2021, and a growing legion of people around the world are testifying that there is a cheap and out of patent drug that is effective against Covid-19, both as a preventative and as a treatment. The drug, which has been used in mass administration campaigns for decades and has an excellent safety record, is being used against Covid-19 mainly in low to middle income countries, and its efficacy is supported by numerous studies and meta-studies, and, perhaps most importantly, by medical practitioners and patients who say they have seen the drug’s positive effects with their own eyes.

The drug is Ivermectin, it is one many drugs that physicians have repurposed to try to treat Covid-19, and the one which has shown the most impressive results, and has the most prominent advocates. Principle among these are Dr Pierre Kory and his colleague and mentor Dr Paul Marik. Both practicing physicians in the field of infectious diseases,  together they have decades of experience in researching and developing therapies for very sick people in intensive care. Marik alone is one of the most published critical care physicians in the world, with 744 publications to his name, to date. Last year, Kory and Marik were early advocates for the use of corticosteroids for hospital patients with medium to severe disease. Their ideas went against orthodoxy on the appropriate use of steroids, and the Lancet warned against it, but it's efficacy is now widely acknowledged, and recommended by the WHO. 

Marik and Kory were encouraged by this clinical advance, but alarmed by what they saw as push-back and delay from the medical establishment, and a centralised, “desk jockey” management approach which undervalues the skills and expertise of front-line practitioners . Marik criticised demands for lengthy randomised control trials on treatments for mortally ill patients as "unethical" in the present situation.  To develop and promote faster and more effective Covid treatments, they set up the Front-Line Covid-19 Critical Care Alliance (FLCCC). 

Their attention then turned to ivermectin. Known to have anti-viral and anti-inflammatory properties. In vitro (test tube) research showed the drug clears viral material of Covid-19 after 48 hours of exposure to it. Kory and his FLCCC colleagues found it to be effective prophylactically (preventatively) and at every stage of the disease, with best results when given at the earliest, viral stage, stopping prolonged suffering, hospitalisation, and death. In November, Kory et al published a paper in preprint compiling evidence for its use from around the world, which, in their opinion, presented an overwhelming evidence based case. The paper is now published in the American Journal of Therapeutics. In December, Kory was called to testify to the US Senate on its use, and spoke of its "miraculous" effects.

Since then, things have not gone well for Kory, who has been treated particularly brutally by Internet giants Google. Google's YouTube community guidelines  specify detailed prohibitions on the promotion of Ivermectin and Hydroxychloroquine as a Covid-19 treatment. 

The video of his Senate testimony was viewed by millions on YouTube, but has long since been removed by them from the platform. His interview with popular UK Covid YouTuber Dr John Campbell has also been removed, and US campaigner Bret Weinstein, who interviewed him at length and has most impressively championed his cause, has had the podcasts pulled and is effectively being driven from the platform.

Elsewhere in the media, coverage of the Ivermectin story has been rare, and usually dismissive. A recent BBC Website article, Covid: Ivermectin to be studies as possible treatment in the UK, does not refer to the arguments and evidence of Kory and his colleagues, or talk to the UK’s leading expert, Prof Tess Lawrie from the BIRD group, whose meta-analysis of the evidence for Ivermectin was published in the same week as this woefully biased article. 

Furthermore, the Principle study, which is the focus of the BBC report, invites participation only from people who have had Covid for up to 14 days. It therefore won't test for prophylaxis and few of its cohort are likely to be given the drug at the earliest viral stage as recommended by the FLCCC, who voiced their concerns about the study design as long ago as January. As their concerns have gone unheeded, the study looks unlikely to “resolve ongoing controversy”, as it’s proponent Dr Stephen Griffiths claims is its purpose. His warning, quoted in the BBC article and in Forbes, that the use of off-label drugs can become "driven by specific interest groups or proponents of non-conventional treatments and becomes politicized,” further suggests that the Ivermectin lobby is not going to to be indulged for long. 

Despite all Kory's medical expertise, his use of the word "miraculous" in the Senate was undoubtedly a huge communications blunder.  For what, at a time when we are all urged to “follow the science”, could sound less scientific than a miracle? Since the beginning of the pandemic, it has been assumed that it must be science that saves us, presumably with effective vaccines, and to this purpose huge resources have been handed to the  medical and pharmaceutical industries. Now some senior clinician has come along and claimed we can do a similar job with a repurposed, out of patent anti-parasitic that is as cheap as chips. It is not a suggestion that has been welcomed. 

Ivermectin is not recommended by the WHO, who say the evidence for it is inconclusive and it should be used in clinical trials only. Similarly, in the US the NIH says there is insufficient data to recommend for or against it. But apart from the UK Principle study, there has been no sign of any genuine impetus or urgency on the part of these agencies towards such trials taking place to reach a conclusion about the evidence, either for or against. The NIH have, however, announced a $3bn investment to develop new antiviral therapies.  One recipient of US federal funds for such new drugs are Merck, the former patent owners of Ivermectin. The Biden administration 

“will procure approximately 1.7 million courses of an investigational antiviral treatment, molnupiravir (MK-4482), for COVID-19 from Merck, pending emergency use authorization (EUA) or approval from the U.S. Food and Drug Administration (FDA).”

Emergency Use Authorisations, it should be added, were required for all early vaccination roll-outs. For an EUA to be issued, it is required that there be no safe and available medical alternative. 

Merck, of course, warns strongly against the use of their old and unprofitable drug Ivermectin for Covid-19.

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It’s understandable and fairly rational for people to assume Ivermectin can't be what its advocates have claimed, because it surely can’t be true that the medical establishment would, or could, deliberately obstruct its development and use as an effective drug therapy. That would be crazy, and it is a conspiracy theory to suggest they have. It is only sensible to assume, for one thing, they wouldn’t want to stop it, and for another, they wouldn’t be able to stop it. Surely, if the drudge works, and doctors around the world are seeing that it works, then the truth about it would spread like wildfire, and no amount of  resistance from on high could suppress the truth for very long. 

Well, it may be a crazy thing to do, and it does imply some level of conspiracy, but that does not mean it is not so. Which is not to say that Ivermectin is everything it is cracked up to be, but only that the scientific, medical and media establishment are set against it, and working against it. 

 

Kory, Marik, Lawrie and all their colleagues are not peddlers of alternative therapies and medical snake oil salesmen, they are highly respected and talented clinicians, with long track records in successful and conventional medical practice. What could their motivation be, to work so assiduously to dismantle their own reputations by campaigning for a drug that does not work? Can they seriously be so wrong?  If you examine their credentials and listen to them speak, you can't be in any serious doubt that Kory and his FLCCC colleagues, who have between them treated thousands of patients for Covid, are only doing what they have always done in their professional lives; they are treating patients with the drugs and therapies they have discovered work best. They are carrying on with this work, day in, and day out, with great dedication, and with no evident conflicting interest. It is only when they try to share their best practice with other physicians through the channels that are available to them that they hit a wall. 

For a simple layman, like myself, it seems perverse, grotesque even, that a drug which is given to everyone in certain parts of the world cannot be given a proper chance to work here, as a remedy for early stage Covid-19, and as a preventative for people living with them, when at present all these people are given is an order to stay at home, take a painkiller if necessary, and hope for the best. Why has it not been given a go, as they have elsewhere, with all the reports of positive results, and no reports of ill effects? 

And why the media shutdown? Why are the FLCCC rubbished on Wikipedia, and deleted from YouTube? Why is there nothing about them or similar groups on the BBC or CNN? Why the clear intention to stifle, if not crush, what they have to say on the issue? For something (we should remind ourselves) that is only supposed to lack sufficient data to recommend it. 

The answer is, I think, depressingly familiar: we now live in a self-censoring and censorious culture which earnestly believes that the best way to do the right things is to actively direct people away from thinking and saying the wrong things. In almost every setting, there is a right message, and a wrong message; the right message will do good, and the wrong message will do harm, and is deemed to be misinformation or fake news or hate speech. 

The people in our media institutions increasingly seek to influence us, rather than to investigate; to encourage what’s thought to be good and discourage what’s thought to be bad rather than to impartially find out what is true, and tell that truth. Investigative journalism does go on, but only if it serves some pre-determined purpose (to demonstrate the corruption of the government, perhaps, or to highlight racism). The Ivermectin story does not promote cherished public health messages, like the observance of social distancing or the benefits of vaccinations, and is dismissed or avoided as uninteresting or suspicious.

The case for Ivermectin is massively undermined by its popularity with anti-vaxxers, anti-lockdowners, anti-maskers and other bad fellows “on the fringes” who are widely portrayed as the problem, not the solution, in our battle against Covid-19. In recent months, for example, a red postcard has been printed and circulated calling for vaccinations to be ended in favour of widespread use of Ivermectin. Supporters are urged to send these to the Prime Minister Boris Johnson, and every day, no matter how small or large that pile of postcards on the doormat of 10 Downing St may be, the message is thrown, literally and metaphorically, into the bin.

An established association with the wrong sort of people is more than sufficient reason, to many minds, to dismiss the science and evidence behind Ivermectin as bogus. The same thing happened with the Covid origin issue; President Trump’s claim that Covid-19 came from a lab was profoundly influential on opinion, even though his opinion had no bearing on the actual truth.

Promotion of Ivermectin is seen, with a small degree of justification, as something which might undermine the government’s aim to get everyone vaccinated. This is now the “great work” of our government, of governments around the world, and of international agencies, like UNESCO, who aim to support the delivery of 2 billion Covid vaccinations worldwide.

But leaving aside the rights and wrongs of vaccinations and who should get them, is it really possible that information about treatments for Covid-19 is being suppressed, and, indeed, withheld, just so that the positive message about vaccines and future new treatments are not disrupted?  

Sadly, it would seem so.  One “Covid disinformation debunking” paper, which trawled through Kory et al’s preprint to identify reasons to doubt each evidence source: Ivermectin: COVID-19 Miracle Cure or Cruel Hoax?  makes precisely this argument in its abstract:

"The campaign to promote ivermectin harms public confidence in drug regulation, the last thing that is needed during a raging pandemic, particularly when the anti-vax movement  threatens to increase vaccine hesitancy."

Following the incredible effort to dismiss the lab leak hypothesis as misinformation, Ivermectin looks like another hugely important story that the scientific and media establishment are trying to suppress because it fundamentally calls into question the agendas and interests that they are committed to.

The present day arbiters of truth, like Dostoyevsky’s Grand Inquisitor, cannot entertain or tolerate a simple saviour that would jeopardize the great schemes now in place to save us.

There can be no miracles, it is for our own good. 

 Alan Tyler 28 June, 2021