Ivermectin is the new hydroxychloroquine, take 3: Conspiracy theories vs. science
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A couple of months ago Scott Gavura explained why the veterinary deworming drug ivermectin is the new hydroxychloroquine, a repurposed drug touted as a “miracle cure” for COVID-19 despite evidence that is, at best, very weak and, at worst, supportive of the conclusion that ivermectin is ineffective against COVID-19. Then, two weeks ago, I posted a typically lengthy, detailed, and snarky article about how ivermectin is the new hydroxychloroquine. What I meant was that, just as 12-15 months ago the antimalarial drug hydroxychloroquine was the repurposed drug touted as a “miracle cure” for COVID-19 that fizzled when tested with rigorous clinical trials, over the first half of 2021 ivermectin has become the repurposed drug touted as a “miracle cure” for COVID-19. Like hydroxychloroquine, which by the end of last summer I was describing as the Black Knight of COVID-19 treatments, an homage to (of course) the Black Knight in Monty Python and the Holy Grail, belief in ivermectin as a highly effective treatment for COVID-19—that will eliminate the need for vaccines, too!—seems similarly immune to having its limbs hacked off by science, the way that they were for hydroxychloroquine. This post won’t be as long—although it might be as snarky—and will deal more with the conspiracy theories that have cropped up around ivermectin. Unsurprisingly, they’re very similar to the conspiracy theories that cropped up around hydroxychloroquine. Many of these conspiracy theories are being promoted by a group of doctors who bill themselves as the Front Line COVID-19 Critical Care Alliance (FLCCC).

I mentioned the FLCCC in my last post about ivermectin. The reason was because of its role in producing the latest “meta-analysis” of ivermectin clinical trials. Basically, Pierre Kory, one of the founders of the FLCCC, collaborated with Tess Lawrie, the founder of the British equivalent of the FLCCC, the BIRD Group. Both are groups that promote ivermectin, although the FLCCC promotes more than just ivermectin. For instance, FLCCC promotes protocols such as the I-MASS protocol, touted as an “in-home” treatment protocol for COVID-19 that involves vitamin D3, melatonin, aspirin, a multivitamin, a thermometer, and an antiseptic mouthwash. Another FLCCC protocol is I-MASK, which is promoted as an outpatient treatment protocol and involves ivermectin, zinc, melatonin, various vitamins, and fluvoxamine. The FLCCC’s most “advanced” protocol is MATH+, a hospital treatment protocol that involves—of course!—ivermectin, plus zinc, fluvoxamine, and a bunch of other vitamins and supplements, along with steroids and anticoagulants. None of these protocols has anything resembling solid evidence from randomized clinical trials to support it.

“The biggest crime committed during the [COVID-19] heist”?

The introduction above brings me to an article that was posted last week on the website of über-quack Joe Mercola, titled “The Biggest Crime Committed During Vaccine Heist“. You can see from the very title the implied conspiracy, namely that evidence for the efficacy of ivermectin is being “suppressed” so that vaccines can be foisted on the world, to the enormous profit of big pharma. Of course, Mercola, as he was before, is very impressed with Tess Lawrie and the “evidence” of her recent meta-analysis, featuring an interview with her on the Speaking Naturally podcast. Since I already deconstructed that meta-analysis in detail the other day and there now exists another, even better, explanation by epidemiologist Gideon Meyerowitz-Katz explaining why that meta-analysis is a bad one that, with a very minor change in classification of studies included, results in a completely negative finding, I won’t be repeating that analysis, although I will point to another meta-analysis that has been published since Tess Lawrie’s meta-analysis, published last week in Clinical Infectious Diseases, the official journal of the Infectious Diseases Society of America, by investigators from Brazil, Peru, and the US.

In brief, the investigators searched for published and preprint randomized controlled trials (RCTs) assessing ivermectin effects on COVID-19 adult patients were searched through March 22, 2021 using five search engines. The primary outcomes examined were all-cause mortality, length of stay (LOS), and adverse events (AE). Secondary outcomes examined included viral clearance and severe AEs. Risk of bias (RoB) was evaluated using Cochrane RoB 2·0 tool. Inverse variance random effect meta-analyses were performed, with quality of evidence (QoE) evaluated using GRADE methodology.

The results:

Ten RCTs (n=1173) were included. Controls were standard of care [SOC] in five RCTs and placebo in five RCTs. COVID-19 disease severity was mild in 8 RCTs, moderate in one RCT, and mild and moderate in one RCT. IVM did not reduce all-cause mortality vs. controls (RR 0.37, 95%CI 0.12 to 1.13, very low QoE) or LOS vs. controls (MD 0.72 days, 95%CI −0.86 to 2.29, very low QoE). AEs, severe AE and viral clearance were similar between IVM and controls (all outcomes: low QoE). Subgroups by severity of COVID-19 or RoB were mostly consistent with main analyses; all-cause mortality in three RCTs at high RoB was reduced with IVM.

Notice that last sentence. The RCTs with high risk of bias demonstrated significant reductions in all-cause mortality in patients suffering from COVID-19. In any case, contrary to the findings of Lawrie’s meta-analysis, there weren’t really any good high quality trials. I also note that these authors didn’t include one of the studies (Elgazzar 2020) that Meyerowitz-Katz described as having “no information whatsoever on allocation concealment at all, and the two sentences on randomization procedures actually contradict each other, yet it is still rated as ‘low risk of bias’ for both of these fields”. It’s also one of the studies that, when removed from Lawrie’s meta-analysis, resulted in a positive meta-analysis becoming negative. As far as the other, Niaee 2020: this newer meta-analysis rates this study as having a high risk of bias—appropriately so, in my opinion.

This meta-analysis concludes:

In conclusion, in comparison to SOC or placebo, IVM did not reduce all-cause mortality, length of stay, respiratory viral clearance, adverse events and serious adverse events in RCTs of patients with mild to moderate COVID-19. We did not find data about IVM effects on clinical improvement and need for mechanical ventilation. Additional ongoing RCTs should be completed in order to update our analyses. In the meanwhile, IVM is not a viable option to treat COVID-19 patients, and only should be used within clinical trials context.

Let’s just say that, based on its methodology and more appropriate assessment of risk of bias, I think that this meta-analysis is more likely to be correct than Lawrie’s.

Then, on Friday, yet another study showed up in the literature. The study describes IVERCOR-COVID19, a randomized, double-blind, placebo-controlled trial. It’s a decent-sized randomized controlled study, 501 patients, in which ivermectin was tested for its ability to prevent hospitalization in patients diagnosed with COVID-19. Patients were randomized to either ivermectin (N = 250) or placebo (N = 251) arms in a staggered dose, according to the patient’s weight, for 2 days. The trial was carried out from August 19, 2020 and February 22, 2021 in the province of Corrientes, Argentina by the Ministry of Public Health of the Province of Corrientes in coordination with the Corrientes Institute of Cardiology “Juana F. Cabral”. Patients over 18 years of age residing in the province at the time of diagnosis of COVID-19 by PCR for SARS-CoV-2 within the last 48 hours before enrollment were eligible. Exclusion criteria included current home oxygen use or hospitalization at the time of diagnosis; history of COVID-19 hospitalization; breastfeeding women; known allergy to ivermectin; presence of mal-absorptive syndrome; presence of any other concomitant acute infectious disease; known history of liver disease; need for dialysis; concomitant use of hydroxychloroquine or chloroquine; or use of ivermectin up to seven days before randomization.

And the results? Nada. Zilch. Bupkis:

In the IVERCORCOVID19 trial, in patients with a positive COVID-19 nasal swab by RT-PCR technique in the last 48 h, ivermectin in a staggered dose according to the patient’s weight for 2 days had no significant effect on preventing hospitalization of patients with COVID-19. No significant differences were observed in secondary outcomes such as the time elapsed from study enrollment to hospitalization in those who required it. Additionally, no significant differences were observed in the use of invasive mechanical ventilatory support, the requirement for dialysis, negative nasal swabs at 3 and 12 days after study enrollment, or in all-cause mortality. Patients who received ivermectin required invasive mechanical ventilatory support earlier. The use of ivermectin was not associated with increased adverse events.

There was no significant difference in mortality, although the trial was not powered to find a difference in this endpoint, and the increased need for mechanical ventilatory support in the ivermectin group could easily have been due to random chance because the total number of patients who required it in the study was small.

Is this study the be-all and end-all? Of course not. It had a lower rate of hospitalizations and was—shall we say?—overly optimistic in its power calculations, assuming a high rate of efficacy for ivermectin, with an odds ratio of 0.3 to 0.5, which translates into an estimated 50-70% reduction in hospitalization, which means that this trial doesn’t rule out a lower level of efficacy for ivermectin. This study is, however, yet another in the drip-drip-drip of negative studies of ivermectin that is becoming very reminiscent of the drip-drip-drip of negative studies for hydroxychloroquine a year ago.

None of this stops Tess Lawrie from going into conspiracy theories about the “suppression” of ivermectin.

Tess Lawrie the conspiracy theorist

The first observation I feel the need to make about Tess Lawrie’s interview is a simple one. She promotes herself as a “respectable” researcher whose work on ivermectin is being scorned due to the nefarious machinations of big pharma and the ideological blindness of other physicians, which leads me to a word of advice. The last thing a “respectable researcher” wants to do is to be featured by Joe Mercola or to be interviewed on a podcast like Speaking Naturally. Why? It’s the official podcast of the Alliance for Natural Health, a pro-quackery group that’s rabidly antivaccine. Let’s just say that ANH-USA is not just antivaccine, but promotes cancer quackery (such as Stanislaw Burzynski’s antineoplastons), among other pseudoscience. Particularly amusing to me has been the ANH-USA’s ranting against state medical boards that actually try to rein in quacks. Less amusing is ANH-USA’s activity promoting laws to make it easier for quacks to practice and advertise their quackery, as well as so-called “right-to-try” laws. Again, this is not the sort of group you want to appear with if you want any serious scientist or academic physician to take you and your work seriously. The ANH-USA is really just one step above Mike Adams or Alex Jones—maybe.

Here’s the podcast:

(I love the takeoff on the e.r. opening credits to try to make it seem as though there is medical authority to this podcast. Nice touch, if you’re a quack.)

Let’s look at Mercola’s bullet points:

  • While the list of crimes committed by authorities during the COVID-19 pandemic is a long one, perhaps the biggest crime of all is the purposeful suppression of safe and effective treatments, including ivermectin. This appears to have been done to protect the COVID “vaccine” program
  • The COVID shots were brought to market under emergency use authorization (EUA), which can only be obtained if there are no other safe and effective alternatives available
  • Several systematic reviews and meta-analyses of studies looked at ivermectin for the prevention and treatment of COVID-19 infection. A rapid review performed on behalf of the Front Line COVID-19 Critical Care Alliance (FLCCC) in the U.S., January 3, 2021, found the drug “probably reduces deaths by an average 83% compared to no ivermectin treatment”
  • According to a more recent review and meta-analysis, ivermectin, when used preventatively, reduced COVID-19 infection by an average 86%
  • Another recent scientific review concluded ivermectin produces large statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance

See what I mean? The idea is the same idea that I heard incessantly over a year ago about hydroxychloroquine, namely that the evidence for the overwhelming efficacy of HCQ against COVID-19 is being “suppressed” in order to protect the profits of big pharma, which at the time was developing new antivirals and, of course, the COVID-19 vaccines, the latter of which have been enormously effective and successful since the release of the first two vaccines under an emergency use approval (EUA) in December 2020.

To set the stage, Mercola goes on and on about how a “gold standard review” of the evidence for ivermectin supports its use, reporting a 62% reduction in mortality due to the coronavirus associated with use of the drug. Again, that meta-analysis shows nothing of the sort, because of the principle of “garbage in, garbage out.” In fact, the highest quality clinical trials thus far all show no detectable effect from ivermectin on COVID-19 hospitalizations or mortality. He then pivots to how the World Health Organization is supposedly “suppressing” ivermectin.

Which brings us to the conspiracy theory:

But why? Why don’t they want people to feel confident that there’s treatment out there and that COVID-19 is not the death sentence they’ve been led to believe it is? The short answer is because ivermectin threatens the vaccine program. As explained by Andrew Bannister in a May 12, 2021, Biz News article:15

What if there was a cheap drug, so old its patent had expired, so safe that it’s on the WHO’s lists of Essential and Children’s Medicines, and used in mass drug administration rollouts?

What if it can be taken at home with the first signs COVID symptoms, given to those in close contact, and significantly reduce COVID disease progression and cases, and far fewer few people would need hospitalization?

The international vaccine rollout under Emergency Use Authorization (EUA) would legally have to be halted. For an EUA to be legal, ‘there must be no adequate, approved and available alternative to the candidate product for diagnosing, preventing or treating the disease or condition.

The vaccines would only become legal once they passed level 4 trials and that certainly won’t happen in 2021 … The vaccine rollout, outside of trials, would become illegal.

The vaccine manufactures, having spent hundreds of million dollars developing and testing vaccines during a pandemic, would not see the $100bn they were expecting in 2021 … Allowing any existing drug, at this time, well into stage 3 trials, to challenge the legality of the EUA of vaccines, is not going to happen easily.

Why, then, would the WHO “suppress” this suppose miracle cure for COVID-19? I bet you can guess where this is going. Enter Bill Gates!

Because, of course Bill Gates is involved:

The WHO’s rejection of ivermectin only makes sense if a) you take into account the EUA requirements; and b) remember that the WHO receives a significant portion of its funding from private vaccine interests.

The Bill & Melinda Gates Foundation is the second largest funder of the WHO after the United States, and The GAVI Alliance, also owned by Gates, is the fourth largest donor. The GAVI Alliance exists solely to promote and profit from vaccines, and for several years, the WHO director-general, Tedros Adhanom Ghebreyesus, served on the GAVI board of directors.16

And, of course, according to Joe Mercola Merck is in on it, because its patent on ivermectin expired 25 years ago and it no longer makes much money off of the drug, although it did receive a $356 million contract from the US government to develop an antiviral treatment for COVID-19.

Besides quoting the bad meta-analysis by the BIRD Group, Mercola cites the FLCCC and its bad science. If you’ve been reading this blog more than a year and a half, ask yourself if this passage sounds familiar to you:

The FLCCC also points out that ivermectin distribution campaigns have resulted in “rapid population-wide decreases in morbidity and mortality,” which indicate that ivermectin is “effective in all phases of COVID-19.” For example, in Brazil, three regions distributed ivermectin to its residents, while at least six others did not. The difference in average weekly deaths is stark.

In Santa Catarina, average weekly deaths declined by 36% after two weeks of ivermectin distribution, whereas two neighboring regions in the South saw declines of just 3% and 5%. Amapa in the North saw a 75% decline, while the Amazonas had a 42% decline and Para saw an increase of 13%.

You might recall that this is exactly the same sort of argument that was made for the efficacy of hydroxychloroquine a year ago. Comparing the rates of COVID-19 deaths in various countries based on their use of hydroxychloroquine was risibly bad science then, and comparing the rates of COVID-19 deaths in various regions in Brazil based on their use of ivermectin now is equally risibly bad science now. Funny how the FLCCC doesn’t mention India. In May, ivermectin was being offered to every citizen of India as the pandemic was killing thousands of people a day in that country. This somehow lead to bizarre claims that ivermectin was “crushing” COVID-19 in India, claims based on highly dubious “analyses” supposedly correlating ivermectin use with decreased numbers of deaths in various regions of India. Ultimately, the Indian health ministry ditched ivermectin as a recommended treatment earlier this month because—surprise, surprise!—it could find no evidence that ivermectin was working. No wonder the FLCCC didn’t mention India.

Tess Lawrie echoes FLCCC conspiracy theories

At this point, it is important to point out that the FLCCC doesn’t just claim that ivermectin prevents and treats COVID-19. That’s not enough for them! No, the FLCCC goes beyond that, claiming that ivermectin also prevents the condition that’s becoming known as COVID long haul syndrome or “long COVID”. This is a syndrome that’s been reported in people who have recovered from COVID-19 but continue to have persistent symptoms for weeks or even months later that include fatigue, “brain fog”, persistent loss of taste or smell, persistent cough, shortness of breath, and other chronic problems. It’s estimated that somewhere between 10% and 33% of those who recover from COVID-19, even mild cases, can develop long haul symptoms.

Back to the FLCCC:

The FLCCC believes ivermectin may also be an important treatment adjunct for long-haul COVID syndrome. In their June 16, 2021, video update, the team reviewed the newly released I-RECOVER protocol.

Keep in mind that ivermectin is not to be used in isolation. Corticosteroids, for example, are often a crucial treatment component when organizing pneumonia-related lung damage is present. Vitamin C is also important to combat inflammation. Be sure to work with your doctor to identify the right combination of drugs and supplements for you.

Last but not least, as noted by Kory in this video, it’s really important to realize that long-haul syndrome is entirely preventable. The key is early treatment when you develop symptoms of COVID-19.

Of course, steroids, at least, are known to be effective in preventing the most severe lung damage from COVID-19. They’re no panacea, of course, but they work. The amusing thing is that dexamethasone, the steroid most widely used to treat severe COVID-19, is dirt cheap, having been off patent for a very long time. Although the FLCCC does include dexamethasone (or other corticosteroids) in its protocol, one wonders why the conspiracy theorists don’t spin conspiracy theories about dexamethasone being “suppressed” because it’s so cheap and pharma can’t make enough money selling it. Oh, that’s right! It’s because steroids aren’t being “suppressed”! That’s because, unlike the case for ivermectin, HCQ, and all the other vitamins and treatments other than steroids in the FLCCC’s various COVID-19 protocols, steroids have actually been shown scientifically to work. Funny that!

Now let’s revisit the video above of Tess Lawrie appearing on the podcast of the quackery-promoting group ANH-USA. I must admit that I nearly spit up my coffee laughing when she started out describing how she had formed a nonprofit company called Evidence-Based Medicine Consultancy, Ltd. to “accommodate this new work we’re doing around ivermectin and other COVID-related research,” but, more risibly, how her company is “completely independent and has “no conflicts of interest.” Seriously? As I mentioned last time, she founded an organization, the BIRD Group, whose purpose is to promote the use of ivermectin! That’s a pretty hefty conflict of interest in my books! That’s why I was totally unsurprised to see her immediately pivot to the same conspiracy theory that the FLCCC and Joe Mercola are promoting, namely that there’s no incentive for big pharma to research ivermectin because it’s so cheap, which is true but misleading in that it is the grain of truth in the conspiracy theory that undergirds the other claims, namely that the WHO, Bill Gates, Merck, big pharma, and the rest are “suppressing” ivermectin in order to protect the vaccine program and the massive profits that it can bring.

Lawrie even uses the same bad science that I described above when she touts how Peru used ivermectin last year and “greatly benefited from it” but that a new president took over and stopped its use leading to—you guessed it!—a resurgence of COVID-19:

Of course, some of the investigators from the meta-analysis I discussed earlier are based in Peru.

Be that as it may, it seemingly never occurs to Lawrie that there might be a number of other causes for such an apparent occurrence. In any event, if you’re using anecdotal evidence that confuses correlation with causation that’s as bad as what was used by astroturf groups that promoted HCQ a year ago (and are using the same bad arguments to promote ivermectin as well now), I really have to wonder how you managed to get a PhD.

Basically, Tess Lawrie is all-in on conspiracy theories. She even goes on and on about how the “mainstream media are colluding” to suppress ivermectin, because of course she does. And look at some of the imagery in the podcast:

There’s nothing like an image of gravestones in a cemetery to make your point!

I once argued that all science denial is a form of conspiracy theory. The FLCCC, BIRD Group, and Tess Lawrie illustrate a corollary of that principle, which is this: If you sense that conspiracy theories are being used to support a seemingly scientific argument, you should look deeper. Use of conspiracy theories to support an argument, are almost always a very good indication that what is being promoted is ideologically motivated bad science and/or pseudoscience. I see nothing in the FLCCC or BIRD Group that disabuses me of that rule of thumb. That goes double when the FLCCC claims that ivermectin works based on bad science, while claiming that doing a proper placebo-controlled randomized controlled clinical trial would be “unethical” because they already “know” that ivermectin works against COVID-19, spurning such trials because “people are dying.”

Unfortunately, conspiracy theories, once born, are almost impossible to kill.

The disinformation war to promote ivermectin has only just begun

I’m getting a definite feeling of, as Yogi Bera would put it, “déjà vu all over again.” What do I mean? Just as the evidence started strongly trending against hydroxychloroquine as a COVID-19 treatment a year ago, the evidence appears to be strongly trending against ivermectin as a COVID-19 treatment. Indeed, ivermectin seems less likely to be effective based on a simple observation, namely that the concentration required to achieve antiviral effects in cell culture are several times higher than what can be achieved in the bloodstream of human beings. Of course, it’s possible that there’s another mechanism not captured in cell culture by which ivermectin could exhibit antiviral effects, but there’s a general rule in drug development that relies on Bayesian analysis. Basically, if a drug can’t achieve an effective concentration in the bloodstream that matches the concentration needed in cell culture, that means it has a low prior probability of working in animals or humans. Combine a low prior probability from basic science with equivocal clinical trials, and you have a drug that almost certainly doesn’t work.

That hasn’t stopped the campaign to promote ivermectin, though. Just the other day, Anna Merlan published an article in Vice titled “The Ivermectin Advocates’ War Has Just Begun“. It’s a depressing read mainly for its contrast with hydroxychloroquine because, after clinical trials turned resoundingly negative for hydroxychloroquine, the more mainstream promoters of the drug backed off, leaving just the hard core conspiracy theorists still pushing it. (Indeed, not even the FLCCC promotes hydroxychloroquine.) Yet the promotion of ivermectin continues apace, using a narrative in which proponents of the drug are being “silenced,” much as antivaxxers now claim they are being “silenced.” (Unsurprisingly, many—but, in fairness, not all—ivermectin advocates are also antivaccine.)

Merlan starts with the story of Ivory Hecker, a former local TV reporter who was fired and accused her ex-employers of “muzzling her for not letting her cover Bitcoin and hydroxychloroquine”. Now, she’s all-in for ivermectin:

The coverage extended also to ivermectin, Hecker claimed, the anti-parasitic drug that several fringe doctors and less-fringe media personalities are claiming is a miracle preventative and cure for COVID-19. That claim has now led Hecker, post-firing, into the company of a new set of friends: the Front-Line Critical Care COVID-19 Alliance (FLCCC), a group of ivermectin-promoting doctors and their allies. On a weekly conference call, which was free and open to the public, Drs. Pierre Kory and Joseph Varon, two of the FLCCC’s founders, lightly interviewed Hecker and heavily implied that all three of them are under the same oppressive thumb of censorship, being silenced by the forces of media, Big Pharma, and their unnamed co-conspirators.

“I’ve left two jobs” in medicine, Kory said, shortly after Hecker declared her gratitude that she’s not in jail for her beliefs. “I was attacked and harassed by two different employers and I left.” What was happening to all of them, he said, was a signal of how oppressive the public sphere has become for people who speak out: “In a certain sense, I’d like to believe it’s gotten so absurd that we now have to pay attention and do something and fix it. This can’t go on.”

The conspiracy mongering includes claims that, because of government, medical, media, and (of course!) big tech’s “suppression” of discussions of how great ivermectin is for COVID-19, lots and lots of people have died unnecessarily. How many? Well…:

Ivermectin advocates believe themselves to be fighting against the forces of censorship to promote a suppressed cure for COVID-19. (Asked during a question and answer session how many people had been killed by social media censorship against ivermectin, Kory and Varon offered estimates in the six figures.) Despite the fact that the drug’s effectiveness at treating any kind of viral infection is far from clear, their holy war has taken on new vigor over the past several weeks, as prominent members of the so-called “Intellectual Dark Web” have begun advocating for the drug—and have found themselves running afoul of policies meant to prevent platforms being used for the advocacy of unproven medical claims.

Even worse, the conspiracy theories and claims of “suppression” are money-makers:

Their claims of suppression are also making ivermectin’s biggest promoters ever more famous. Kory announced this week that he’ll be following up on his appearance on Joe Rogan’s podcast, where he preached the gospel of ivermectin to millions, with an appearance on Dr. Drew. But on their weekly Zoom call, Varon and Kory agreed with Hecker, the fired reporter they were interviewing, that something truly sinister was taking place. Kory hinted at a new theory that may begin to take shape in the ivermectin sphere, asserting that something called the “Trusted News Initiative” may be to blame for ivermectin’s lukewarm reputation in the mainstream media.

“A large part of the major mass media have made a decision that they’ll only allow discussion on what’s determined to be correct and efficacious by the WHO and the NIH,” he said. That decision seemed be linked, he implied, to the Trusted News Initiative, an project begun in 2019 involving a group of news organizations trying to agree on new standards and technologies to combat disinformation, most recently around elections and vaccines, and to provide continuing education resources to help journalists learn how to identify things like manipulated images.

In other words, predictably, the conspiracy theory is…evolving. It’s becoming wider, in order to become a broader conspiracy theory that portrays efforts by journalists and the mass media to combat disinformation and help journalists identify manipulated images and real “fake news” (news that is fake, compared to real news that politicians call “fake news” because it’s a threat) as a threat to whatever the conspiracy theorists believe in.

Ivermectin as a “cure” (or at least a highly effective treatment) for COVID-19 is basically science denial. It is still possible that science will show ivermectin to be effective against COVID-19, but from my perspective that outcome is looking less and less likely. Thus, not surprisingly, the promotion of ivermectin requires denying the inconvenient science, with all the techniques of denial used by denialists ranging from creationists, to antivaxxers, to cancer quacks, to climate science deniers being marshaled against disconfirming science. Because all science denial includes a conspiracy theory, we should therefore not be surprised that ivermectin advocates have not only embraced conspiracy theories about the “suppression” of their favored COVID-19 cure, but have gone beyond that to go even bigger on the conspiracy mongering to portray any effort to combat disinformation as a grand conspiracy to suppress The Truth about…everything.

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