Ivermectin for COVID-19 in Peru: 14-fold reduction in nationwide excess deaths, p=.002 for effect by state, then 13-fold increase after ivermectin use restricted

On May 8, 2020, Peru’s Ministry of Health approved ivermectin (IVM), a drug of Nobel Prize-honored distinction, for inpatient and outpatient treatment of COVID-19. As IVM treatments proceeded in that nation of 33 million residents, excess deaths decreased 14-fold over four months through December 1, 2020, consistent with clinical benefits of IVM for COVID-19 found in several RCTs. But after IVM use was sharply restricted under a new president, excess deaths then increased 13-fold.

Methods

To evaluate possible IVM treatment effects suggested by these aggregate trends, excess deaths were analyzed by state for ages ≥ 60 in each of Peru’s 25 states. To identify potential confounding factors, Google mobility data, population densities, SARS-CoV-2 genetic variations and seropositivity rates were also examined.

Results

The 25 states of Peru were grouped by extent of IVM distributions: maximal (mass IVM distributions through operation MOT, a broadside effort led by the army); medium (locally managed IVM distributions); and minimal (restrictive policies in one state, Lima). The mean reduction in excess deaths 30 days after peak deaths was 74% for the maximal IVM distribution gr...