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Ivermectin
Episode 11st November 2021 • AgriSafe Talking Total Farmer Health • AgriSafe
00:00:00 00:15:02

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Episode Credits:

Created by AgriSafe Network with support from the National Library Of Medicine of the National Institutes of Health under Award Number UG4LM012345. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.”

Written by Laura Siegel

Hosted by Abigail Kahrs

Edited by Joel Sharpton

Special Guests: Dr. Jeff Bender and Sarah Dauterive

Transcripts

Carey:

Welcome to the Talking Total Farmer Health podcast from AgriSafe Network. At AgriSafe we work to protect the people that feed the world. We do this by supporting the health and safety professionals ensuring access to preventative services for farm families and the agricultural community. Today’s episode is brought to you by the Network of the National Libraries of Medicine Region 3.

Abigail:

For the past year and a half, it feels as if we have gotten a lot of mixed messages from the news and social media on what products can help prevent, treat, and cure COVID-19. Maybe you heard somewhere that Ivermectin is one of those products. We decided to investigate these claims to find out what exactly Ivermectin is, and what it’s used for.

Dr. Bender:

You know Ivermectin has been around for a long time in veterinary medicine and it’s an important drug. It is an FDA approved product for a number of different animals including horses and cattle, swine, and dogs and cats.

Abigail:

This is Dr. Jeff Bender, a veterinarian for both small and large animals, epidemiologist, and director of the Upper-Midwest Agricultural Safety and Health Center.

Dr. Bender:

It is an anti-parasiticide, in other words it kills parasites, so things like lung worms and stomach worms and round worms, as well as mange mites, so it’s really an amazing drug and has very specific purposes in veterinary medicine.

Abigail:

Most people who have heard of Ivermectin know it as a drug just for horses,

Dr. Bender:

And for a lot of people, they might recognize it also as a heartworm preventative for their dogs, that you would often use, you know, that monthly pill that you would give to your dog. So, it’s an incredibly important veterinary product.

Abigail:

Now, you might be wondering… if Ivermectin is a veterinary drug, then why are there claims that people can take it to treat COVID-19? Well, it has to do with the emergency-use authorizations for COVID-19 vaccines, and the long process it takes for scientists to find and test different potential products.

Dr. Bender:

You know one of the things is to try to come up with treatments and preventatives as quickly as possible. So as scientists, we know we explore a number of different questions about which products might be useful. And, you know, when the pandemic started, there was a long list of products that scientists say, “okay, hey, we’re gonna explore these possibilities that might affect this virus.” And so, we’ve been going through that list in a sense, and Ivermectin is one of those products. There’s a really formal approval process to really evaluate which products work and which don’t. And so, Ivermectin is one of those ones that actually has been of interest just because there’s been some of what we call invitro studies, so studies in cells, where it looks like it inhibits the replication of the virus. And, you know, this study came out, you know, last year.

Abigail:

Johns Hopkins notes that the vaccine development and testing process often lasts 10 or more years. So one year is barely even in the beginning stages. But without that knowledge in mind, it’s easy to jump to conclusions. And with those one year studies…

Dr. Bender:

People jumped and said, “Well this has got to work.” But, I would really caution that this is very early and there is very limited data and it needs to go through a really, a formal what we call a peer-review process, to evaluate if it works or not. So that’s actually part of why this interest in Ivermectin has come about, and it is just one of many products that are being evaluated by the scientific community. We have some other newer drugs that have actually gone through a farther-along approval process, that are approved. For Ivermectin, it’s very much in its infancy. As I mentioned, there was what we call an invitro study, so it wasn’t done in animals or humans, it was done in cells, and so they were able to demonstrate that the virus, they could control virus replication, and it was a very high concentration.

Abigail:

And it’s not safe or sustainable for a human being to take those high levels of Ivermectin. It can be toxic.

Dr. Bender:

So again… that particular author, they really cautioned and said, “this would require further research to see if it’s actually beneficial as a potential treatment.” Also, there are some very small studies, so it’s in the order of hundreds of people. And maybe thousands. That have documented maybe reduced mortality in its use and a shorter hospital stay. But again those are really small numbers and we really need to be very cautious. And again, these products need to be used under the guidance of, really, a qualified healthcare provider. These are not something that people should take off the shelf and try to use. The veterinary product is not approved for people, it is dangerous, and actually we’ve seen reactions in people that are taking these products. They’re not innocuous. They can cause problems for a number of different people. Just like in animals. You know, we don’t want them to be willy-nilly used in animals. There are some animals that are highly susceptible to toxicity to Ivermectin, and so some people may have these same type of things. So again, we want a qualified healthcare provider who prescribes any product or any treatment, especially for COVID. And there are approved treatments that have shown to be a success, so we want to encourage people to do that.

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Abigail:

So you may be wondering, if there are better doctor and scientist approved products to help treat or prevent COVID-19, then why are people still taking Ivermectin?

Dr. Bender:

In the veterinary realm we’ve been using this as an anti-parasiticide for a long period of time. But also, on the human side, there has been shown to be some approved label uses for humans, specifically in some conditions that occur especially in tropical areas, like strongyloides or river blindness. So these are conditions that we see and actually are approved for uses; except it’s a much lower dose than what is in a veterinary product. But then again, they’re approved and they’re very specific for these particular conditions that are being applied for. So any use outside of that realm is dangerous. And we really want folks to be very cautious. One, to not use the veterinary products cause they’re not labeled for people, they’re not approved for people. But then to also recognize that the human products have very specific indications and that really a qualified physician or healthcare provider needs to prescribe those for that particular condition.

Abigail:

That might explain where some confusions come from if Ivermectin is okay for humans in some circumstances but not others. But we already established that the needed dose to potentially even have any effect on COVID-19 in humans would be toxic and dangerous. So what else is going on here? Why are people taking medications for reasons other than their medically approved purpose? Does it really all boil down to misinformation, or misunderstandings?

Dr. Bender:

You know the pandemic has been interesting phenomena on the human psyche. That’s something that’s been very interesting to me to observe, you know, over the last 5 years, or so, with how information is shared. Really to understand human behavior and human perceptions and the evolving nature of that as we look at communication in general. As a scientist, as a veterinarian, you know, I go by facts. I go, well, this is what at least I understand when I look at this. But, I recognize that many people don’t… they get their sources from varying sources and these might not be the same sources that I get my information from. And so I think that that has led into where people get their information. I think that that’s a critical piece. The other thing is that, with the pandemic there’s fear, and fear drives us to… some sources that we may not, or that we’re not getting the complete picture, and it also gets to an issue of trust. And so how do we make sure we have trusted resources that we’re getting information from. So I think the combination of how were getting it, the type of information that we’re getting, and also the trusted resources are all part of how information and how we get information. So to our producer community, and our farmers, and our farm workers, and our farm families, where they’re getting information. I think they need to ask that question, “is this somebody that I can trust?” And generally my first quick recommendation is try to go to your qualified healthcare provider to give you the best information or to guide your information. Especially if there’s confusion, especially cause there’s so much misinformation out there.

Abigail:

This is Sarah Dauterive, AgriSafe’s Web Technologies Librarian.

Sarah:

Something important to remember when looking at medical or scientific information in particular is that it is written for a specific audience and with a very narrow purpose in mind. There is an entire language you will find in research that is really hard to understand when you haven’t been trained to understand it. And these researchers are writing these journal articles for other researchers, so there is an assumption that the reader has the same level of training that the author has. But when that isn’t the case, there is room for a lot of misinterpretation.

Abigail:

And while misinterpreting information isn’t a new problem, there is much more opportunity for this misinterpretation to have major impacts on society.

Sarah:

Researchers talk about their research with other people in their field through their journal articles. And these journals often cost hundreds of dollars for just a handful of issues and aren’t the type of thing that you’re gonna find in the grocery store checkout aisle. Typically, these are purchased by special libraries. However, that used to require a trip to a physical location where you have to find the information. And then that information isn’t as easily shared outside your personal circle of influence. The internet allows us to access information that was just physically harder to get to in the past. And it also allows us to make connections with more people and in more places than we’ve ever been able to do before. So, the impact that a misinterpretation can have is much greater and happens much faster.

Abigail:

Dr. Bender talked about fear driving how we gather information. Sarah says this is really important to consider, particularly when making health decisions in a pandemic.

Sarah:

When you are in situation where you are driven by fear or some other emotion, you are more likely to make decisions that aren’t backed up by facts. The fear, the grief, the isolation, the frustration that this pandemic has brought us is all expected and real. And it’s okay to feel any of those things or all of those things. But that can cause us to seek out information that gives us the facts we want to trust, not the facts we have. Being aware that our emotion can cause us to make decision not based in science-driven fact will go a long way in helping us make good choices about what information we trust when faced with a lot of misinformation. It seems like a good thing to say “do your research,” but the reality is we can’t all individually understand all things all the time. We need producers who know how to successfully provide us the food, fuel, and fiber we all need to function in society. We need meteorologist to tell us when a hurricane is coming. We need mechanics to fix our vehicles. We rely on experts in our communities to focus on what they are experts in so we can be experts in something else. And we get so much more is accomplished this way! So, when our medical and public health experts give us important information, it is important to believe them.

Abigail:

So where can we go for credible information?

Dr. Bender:

So again, our public health and our community health leaders, they need to be seen as trustworthy resources and so we need to share what we know in that regard. Especially this community needs to emphasize what approved, authorized, and recommended treatments are that people can go to. Ivermectin is approved to treat parasites. It’s not approved to treat COVID-19. So just a reminder that what we know Ivermectin does and what its approved for. We do know that vaccines are safe and effective. I know it’s a kind of controversial area, but we do know or document that we can keep people out of hospitals, we can keep them out of ICU, for the majority of folks. We know that there’s some questions about waning immunity and those types of things, but again vaccines are safe and effective. And then also, you know that we encourage engagement with our healthcare providers. So community leaders, public health leaders that continue to work with our healthcare providers to give them the resources that they need. The other thing that we need to remind ourselves is that people are fearful and we need to be good listeners and listen to their concerns, listen to their fears. There’s a lot of concern about trust in government. So, you know, we need to engage and listen and then provide a resource that is responsive to those concerns and hopefully gain back the trust of our community members. And again, to really encourage those folks to seek information from trusted resources such as their healthcare provider.

Abigail:

I think that’s a great message to end our show on. If you want more information about ivermectin, vaccines, or other COVID-19 related information, check out our show notes. Thanks, Dr. Bender and Sarah, for joining us and answering our questions, and thank you to our listeners for taking some time out of your schedule to listen!

Carey:

Thanks for listening to another episode of Talking Total Farmer Health. Be sure to subscribe to this podcast to hear more from AgriSafe on the health and safety issues impacting agricultural workers. To see more from AgriSafe, including webinars and our newsletter, visit www.agrisafe.org. This episode was created by AgriSafe Network with the Network of the National Library of Medicine Region 3. Written and transcribed by Laura Siegel. Hosted by Abigail Kahrs. Edited by Joel Sharpton. Special guests were Dr. Jeff Bender and Sarah Dauterive.

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