There was some pushback to my last article about the evidence pointing in favour of Ivermectin as a cheap and viable treatment for Covid-19. One respondent sent in a link to an article that purports to show that Ivermectin is not responsible for the incredible success that the large and poor Indian State of Uttar Pradesh (UP) has had in combatting the virus. The article is at a website called www.healthfeedback.org and is titled No evidence suggests a causal link between Ivermectin recommendation and the decline of COVID-19 cases in the Indian state of Uttar Pradesh.
The author or authors state that there is no evidence for the efficacy of Ivermectin when used against Covid in UP, and that the state’s dramatic reduction in Covid-19 cases and deaths can be explained by up to three other factors. Throughout the article UP is often compared to another Indian state – Kerala. Kerala is a much smaller (population thirty-five million at the last census) and wealthier ($3300 GDP per capita) state than UP. Unlike UP, its state government has explicitly rejected the use of Ivermectin in favour of the experimental, and in-patent drug Remdesivir while engaging in an aggressive (by Indian standards) vaccination campaign.
The author suggests one explanation for UP’s low Covid numbers is the state government simply undercounting Covid cases. The articles suggests that the UP authorities are only detecting one case in every one hundred whereas in Kerala they are able to detect 1 in every 6. Except the article throws this allegation out there without supplying any context whatsoever. On October 25th in UP there was a total of nineteen reported new cases or one new case for every 10.5 million people.
If transposed onto Canada that latter statistic would equate to three new Covid cases in the entire nation! Even if we assume the allegation made by the author to be true, that would mean that total number of new cases in UP on that date would be around 1900 people, still fewer than the 2367 new cases recorded in Canada on the same day. By contrast Kerala, with a population similar to Canada’s reported 7427 new cases on the same date.
Alternatively, the author suggests that lockdowns which have also been used by the UP government to try and control the spread of the virus, may explain the state’s good Covid numbers. This begs the question of why lockdowns which have been tried all over the world, mostly without success, would work in UP, a poor jurisdiction with a population density of 830 inhabitants/km2, and nowhere else. Indeed, a recent media story noted the difficulty in getting infected citizens in Kerala to observe proper quarantine procedures. Surely there must be some qualitative difference that the author can point to in UP’s implementation of lockdowns, to justify this theory. No such explanation is forthcoming.
Lastly the author posits that the number of Covid cases in UP have dropped dramatically because a sufficient number of people have been infected and the reservoir of vulnerable people has declined to the extent that the spread of the virus has slowed dramatically. In other words, the state’s population has reached herd immunity. The author bases this argument on data from the fourth nationwide seroprevalence study conducted by the Indian Council of Medical Research (ICMR) in June and July 2021. This showed that over 67% of the Indian population had Covid antibodies – either through previous infection, or through the administration of Covid vaccines. According to the article Kerala had the lowest seropositivity rate of about 44%.
The article attributes this to the state’s early use of vaccination. By contrast UP had a seropositivity rate of 71%. The article implies that this too is due to vaccination, but even today, more than three months after the survey, only 20% of the adult population in UP is fully vaccinated. In June and July when the survey was taken the number was lower yet. Assuming that the data is accurate – then over 50% of UP’s population had contracted or been exposed to Covid by early mid-summer 2021. This is represented as a failure of public health policy in UP.
But if Ivermectin is an effective treatment against Covid then the absolute number of people who contract the disease becomes irrelevant if the risk of serious illness or death is low. Nobody cares about population seropositivity rates for the common cold. Absent a massive death toll, showing that UP has reached herd immunity through exposure to and infection by Covid-19 in no way impugns Ivermectin’s efficacy as a treatment. Indeed, it confirms it. For the only metric that can determine the success or failure of a jurisdiction’s Covid-19 response is the death toll attributable to the disease.
UP, has registered about 23, 000 deaths from Covidfrom Covid-19. Kerala, with a population one sixth the size, has registered 33,000 deaths, a number which is continues to grow by nearly four hundred per day. Likewise, Kerala continues to see a large number of new cases each day.
And it is not only Kerala that suffers in comparison to UP in this statistic. Both Canada (29,000), and Belgium (26,000) for example have suffered more deaths than UP. When adjusted for population, UP has a lower death toll than every European country but Iceland. In order to dethrone the Ivermectin hypothesis, critics need to provide an adequate explanation for UP’s extremely low death rate from Covid-19. This the author of the article in question has signally failed to do.
Most of the industrialized world has attempted to control and defeat the Covid-19 pandemic using a combination of lockdowns, social distancing and more recently, experimental vaccines. For the most part these strategies have failed. Covid-19 infection rates continue to rise in wealthy, heavily vaccinated countries such as Israel, Singapore, and the United Kingdom. Canada will mimic this trend as the protection offered by the vaccines declines in the months following their administration.
Uttar Pradesh adopted similar strategies, but when faced with a massive wave of infections in the Spring of 2021 before vaccines were readily available, it adopted out of necessity a strategy of providing early treatment options to its citizens in which Ivermectin figured heavily. At this point the State appears to have come through the pandemic with a very low death toll and in all likelihood has reached herd immunity.
This disparity of outcome is in fact the strongest evidence in favour of Ivermectin. Unless the haters can find 200,000 dead people in Uttar Pradesh, that evidence will stand.
Drew Belobaba was born and raised in British Columbia. He studied History at Simon Fraser University and law at the University of Saskatchewan and has practiced law in both Saskatchewan and England. He lives in rural Somerset with his wife and three children.