Ivermectin is the signature example of politics trumping health

A year later, the anti-expert instinct Trump had fostered began to show in a different context. States with more Joe Biden voters began seeing much higher rates of vaccination than states that had preferred Trump. The former president’s advocacy was halting and constrained, recognizing that there was more political value in standing against the “so-called experts” than in trying to persuade people to protect themselves against the virus. So his most fervent supporters went looking for more miracles. Florida embraced those antibody treatments. Others began to hype the drug ivermectin.

There was never any evidence that ivermectin was particularly effective at treating coronavirus infections. A smattering of studies suggested that there might be some benefit, but they were limited in scale. By March 2021, the Food and Drug Administration was warning that it hadn’t found any demonstrable benefit from taking the drug to treat covid. But then the delta variant of the coronavirus began to spread, causing particular devastation in states that were less vaccinated and, relatedly, had shown more support for Trump. So many people in those areas sought out ivermectin, convinced that some cure existed beyond the highly effective vaccine promoted by the Biden administration and the “experts.”

We now know with a great deal of confidence that ivermectin does not show any appreciable benefit in treating covid-19. In fact, “volunteers who took ivermectin in the first three days after a positive coronavirus test turned out to have worse outcomes than did those in the placebo group,” as the New York Times reported.

What we don’t know is how many lives might have been lost because of the politicization of ivermectin as an anti-establishment alternative to treatments that did prevent death.

There is no real question that right-wing political leaders touted ivermectin specifically as a way to score partisan points. Consider Rep. Marjorie Taylor Greene’s (R-Ga.) rhetoric last December.

“Ivermectin, monoclonal antibodies, & other treatments are saving lives,” she wrote on Twitter. ” …[O]ur response to #COVID19 should be working towards ending obesity, promote covid treatments that are proven to work, & stop the politically driven mass hysteria.”

“Allow people to choose natural immunity or vaccines, w/o discrimination,” she added. Her account was later suspended for repeatedly sharing coronavirus misinformation.

That formulation — vaccines vs. “natural immunity” gained by catching and recovering from the virus — is key. To justify rejecting effective vaccines, you need to both denigrate the vaccines’ efficacy and propose an alternative. That was the role ivermectin played: It was hyped as something you could take to feel better in the event you caught the virus. Then you get “natural immunity” and you’re covered as well as if you had been vaccinated — if you lived.

The challenge, of course, is that many people didn’t live. The Kaiser Family Foundation estimates that about 163,000 people died during the delta surge because they weren’t vaccinated. Those deaths were disproportionately in places that had preferred Donald Trump in 2020.

The effect of encouraging people to rely on ivermectin was the same as asking them to rely on wishing upon a star: Some would live and might credit ivermectin for their survival. But that was simply coincidental. Those who might have lived had they been vaccinated were not around to instruct people that ivermectin didn’t work.

This was the central problem. People believed this. That includes some legislators, certainly; just because you see something as politically useful doesn’t mean you are doing so cynically. Using a large platform to amplify claims about an unproven treatment, though, would have the predictable effect of people taking it seriously. So we saw myriad cases in which patients or families, convinced that ivermectin was miraculous, sued medical institutions to force the administration of ivermectin. Hospitals were reluctant, given that, unlike wishing on a star, there were potential negative effects of taking the drug. (Poison-control centers noted an increase in calls about ivermectin.)

Those convinced that the drug worked — hearing it from trusted politicians or podcast hosts — saw conspiracy. The establishment was rejecting ivermectin because it wasn’t profitable, they argued. Or they were doing the bidding of vaccine manufacturers. Even the inefficacy of ivermectin was explained away: Hospitals weren’t administering enough! There was always some reason that could be constructed to explain why The Establishment was trying to suppress ivermectin, and those reasons were never that it wasn’t proven to work and that it risked serious side effects.

It’s important to emphasize how ivermectin correlated to politics. Research published last month showed that counties that supported Trump strongly in 2020 were those that saw more ivermectin prescriptions written in the final months of that year, as attention began to turn to the drug. Google searches for ivermectin in August and September of last year were far higher in a number of metropolitan areas that had backed Trump by wider margins in 2020.

Some of this is a function of ivermectin’s approved use in agriculture: rural areas would be expected both to show more support for Trump and to have more animals needing a drug like ivermectin that targeted parasites. But this was also the period in which ivermectin searches surged, so it’s clearly also linked to the pandemic.

Politics both drove and followed the fixation on ivermectin. Right-leaning political leaders and conservative media figures hyped ivermectin as an alternative to vaccination and their followers believed them. Then, conservative political figures responded to the outrage of the base at the pushback on use of the drug with legislation forcing it to be made available. Earlier this month, USA Today wrote about state legislators who seized on the issue to pass laws mandating the prescription of ivermectin when desired, even as the lack of utility of the drug was becoming more obvious.

Others have gone further. A candidate for attorney general in Wisconsin is pledging to launch homicide probes targeting doctors who didn’t prescribe ivermectin. It’s not just believing the hype, it’s leveraging the false confidence in ivermectin for political benefit.

We will never know how many Americans who might have lived had they been vaccinated decided against it, trusting that drugs such as ivermectin would keep them alive. We do know, though, that there was a concerted effort to convince people that ivermectin would do so, an effort that intertwined with partisan rejection of government expertise. We can say with confidence that the atmosphere of disinformation about ivermectin led to people dying who would otherwise have lived.

We know how deadly covid has been. We’ll never know just how deadly this rhetoric was.