Not Using Ivermectin, One Year In, Is Unethical And Immoral

Ivermectin for Covid-19

By Mary Beth Pfeiffer

Withholding ivermectin as a treatment for COVID-19 has entered a new realm: It cannot be defended as medically or morally principled.

Not when a body of strong evidence is amassing in support of the drug.

Not in the fiery throes of a pandemic that is killing roughly 4,000 Americans a day.

Not when ivermectin is a safe, well-tested and inexpensive oral medication.

And certainly not when, as I write this, a tweet comes across my feed from Dr. Ranu Dhillon of Brigham and Women’s Hospital and Harvard Medical School in Boston. He implores:

“We have no beds — ICU or otherwise — left & continue to have patients needing admission in our ER…multiple patients with unrelated problems are also testing Covid-positive.”

I have been writing about early treatment for SARS-CoV-2 infection since March, with my first article on ivermectin, a generic anti-parasitic drug, published on Oct. 1. I concluded then and still believe that this drug, effective at multiple stages of the disease, could turn the corner on COVID.

Incomprehensibly, the people we should trust to make the call on ivermectin are paralyzed by indecision and cowardice. For eight months, while hundreds of thousands died, the National Institutes of Health advised against using ivermectin except in clinical trials. Last week, NIH brushed aside evidence of efficacy in several thousand patients who took ivermectin and decreed there was “insufficient data to recommend either for or against.” 

This, ironically, is progress. It is the same advice NIH has for months given for monoclonal antibodies and convalescent plasma, COVID treatments that are minimally effective and more expensive than ivermectin. Doctors nonetheless embrace those high-tech, in-hospital treatments. But aware of the uproar over another COVID treatment, they steer clear of generic ivermectin, which can actually prevent and treat infections at home and in the hospital.

A Lawsuit, A Life Saved

This article was prompted by the story of an 80-year-old Buffalo woman with COVID whose feisty, take-no-prisoners family took a hospital to court over ivermectin. Such is the state of COVID care in America.

The woman, Judith Smentkiewicz, was on a ventilator when her loved ones were told she’d likely spend another month in the ICU, where they gave her a 20 percent chance of survival. This is the modus operandi of COVID among the elderly and infirm: prolonged, expensive and often fruitless late-stage care.

So the family did some research on behalf of this active octogenarian who drives, lives independently and works five days a week cleaning houses. They went online. They read about studies of ivermectin’s success. They pressed an ICU doctor to give it, and, on day 12 of infection, he did.

Within 48 hours of a single dose, Mrs. Smentkiewicz had improved so much that, like a Florida woman in my first ivermectin article, she was moved out of critical care.

The hitch? Doctors on the new unit declined to continue ivermectin even as the woman’s condition declined. The drug is not approved for COVID, they told her family. The family went to court. The hospital fiercely objected. Mrs. Smenkiewicz’s personal physician for 20 years was called in.

“We reviewed the limited studies on the use of ivermectin for COVID-19 and recommend [his emphasis] she receive 15 mg orally Day 1, Day 3 and Day 5,” wrote Dr. Stephen Scravani in a letter to the court. The judge ordered the treatment resumed.

As a result, Mrs. Smentkiewicz is to be released to a rehabilitation facility shortly. “It is a miracle from where she was,” the family’s attorney, Ralph Lorigo, told me.

This story is instructive for what it says about other late-stage patients, whose COVID sieges instead may end with last rites and a ride to a mortuary. There is a straight line between those outcomes and a dogmatic insistence by NIH, the World Health Organization and other policy powerhouses on large, randomized controlled trials before endorsing ivermectin.

Here’s what is happening while we wait on those RCTs and fail to use the evidence we already have: Emergency rooms are overwhelmed. The ranks explode of people with of long-term COVID damage. And patients – and some doctors and nurses – suffer injury and death.

Benefits At Every Stage

In a Buffalo News article about Mrs. Smentkiewicz, ivermectin was described as “experimental,” an adjective that is correct in a technical, but wholly inaccurate, sense.

Yes, ivermectin is still being studied; but its role is clear. By one analysis, 33 studies so far – involving 10,136 patients – collectively reported positive outcomes in 85 percent of people. There were fewer infections among frontline workers and COVID families; quicker recovery in early and late infection, and lower mortality rates. At least three other meta-analyses have reported similar, statistically significant improvement across disease stages.

By any yardstick, ivermectin is not an experimental drug. Since the 1980s, billions of doses have been given worldwide in ongoing programs to control parasites. In Africa, for example, 99 million people were treated in 2012 alone; in many African countries, not coincidentally, COVID rates are markedly lower.

Ivermectin saved so much human suffering from river blindness and other awful parasitic diseases that it won its developers the Nobel Prize in Medicine in 2015. The scientist who found the substance some 40 years ago in a bit of Japanese soil called it “astonishingly safe” in 2011 and a “wonder drug” in a class with penicillin and aspirin. Other scientists agree it has a stellar safety record.

‘Transformational Treatment’

Fast forward to 2020, when ivermectin began proving its mettle against COVID-19.

To date, we have the combined weight of 51 studies in ivermectin’s favor.

We have the work of Front-line COVID-19 Critical Care Alliance that analyzed those studies, examined South American regions where ivermectin distribution led to fewer cases, and wrote protocols for doctors to follow at each stage. “(I)vermectin may prove to be a global solution to the pandemic,” the group wrote in a peer-reviewed article accepted by the journal Frontiers in Pharmacology.

We have a new independent review from England that concludes “…ivermectin will probably substantially reduce the risk of death in people with COVID-19 and…will probably substantially reduce the risk of COVID-19 infection among health care workers and contacts.”

Lastly, we have what may be the ultimate breakthrough. Working under a program hosted by the World Health Organization, a University of Liverpool pharmacologist reviewed ivermectin studies and was impressed. “If we see these same trends consistently across more studies,” Dr. Andrew Hill concluded, “then this really is going to be a transformational treatment.” Unitaid, the agency overseeing Hill’s work, acknowledged for me that the “preliminary data was promising.”

It’s my hope that WHO will be bold. It must balance the risks and benefits of ivermectin. COVID-19 has changed everything. We do not have time to conduct trials involving thousands of patients and millions of dollars. What should matter now is this: Long-standing science tells us ivermectin is safe. New studies tell us ivermectin works.

Last April, NIH’s COVID czar, Dr. Anthony Fauci, declared the drug remdesivir the “standard of care” based on preliminary findings. “You have an ethical obligation,” he said then, “to let the people in the placebo group know so they could have access.”

We now know that remdesivir, at $3,000 a treatment and approved on thin evidence, does not work. What is your ethical obligation now, Dr. Fauci, when we have a treatment that does?


Mary Beth Pfeiffer is an investigative reporter and author of two books. This is her sixth article for Trial Site News on ivermectin and early COVID-19 treatment. Follow her on Twitter: @marybethpf.

Note that views expressed in this opinion article are the writer’s and not necessarily those of TrialSite News LLC.  


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  1. We agree. It is curious because the Nih, only look at each other, and give priority to the formalism of their approval procedures, rather than the search for solutions.
    It is inadmissible that after almost a year, the tests have not been deepened or streamlined, in promising drugs, such as ivermetin, and others that have also shown that they could help, such as vitamin D, molnuviparir, or Aplidin, which in Spain , in vitro show more potential than remdesivir, and has not yet even begun phase III … and other drugs such as sprays, etc .. the lack of quality information data, monitoring of trials, in real time, as has been done with vaccines, or prioritization and support for those studies that are more promising, use of retrospective analysis, should be possible.

    1. I like to think not. Don’t like being cynical so please give me an option. I can’t find one.
      WHO published 2 big studies and concluded "remdesivir has no benefit against this virus". Less THAN TWO WEEKS LATER, FDA gave it EUA @$3-5K per treatment. Smells doesn’t it? Give me options.

  2. The highly qualified and revered doctors and researchers of the FDA seem have courageously upgraded their learned opinion of Ivermectin to "neutral". According to the NIH Ivermectin is now in the same category as chicken soup? I haven’t seem and trial data on chicken soup that I can recall.

  3. Surely the analyses by Dr. Andrew Hill and Dr. Tess Lawrie show that Ivermectin works, and it seems to me that there is nothing to lose and it’s cheap. I’ve emailed my member of parliament, numerous doctors, academics and the national press but no one seems interested and in here in the UK hospitals are transferring patients hundred of mile to find spare beds.

  4. I have known investigative journalist Mary Beth Pfeiffer for decades, and my respect for her as one of the finest left in a dying profession is boundless. She indefatigably cuts through the righteousness of politically correct baloney and gets to the facts.
    First, an aside. Why is investigative journalism, as I say, a dying profession? Because, I believe, the Powers That Be, the handful of gigantic multinational corporations that own about 96% of all print and broadcast media in the States, prefer to create fact-like statements that further their game plan, and do not want those pesky real facts being published, least of all in their organs of propaganda, revealing the ugly truth behind their intent on securing ever more control and wealth.
    Anyone with at least one cellule of cerebral matter has long since realized that something is very wrong with one set of responses to this plague – yes, Mary Beth is literally the first professional mainstream reporter I have seen use the correct noun rather than safe circumlocutions like "collateral damage" for innocent people caught in the crossfire when the United States invades another petroleum-rich country. This is a plague. Let’s all say it together. PLAGUE.
    New Zealand, Japan, China, and parts of Europe are getting the upper hand. Even nations you might not expect to be succeeding, like populous Tanzania and Brunei, have impressively reduced their infection and mortality rates. But those countries that supposedly have the experts and the money to address this plague accurately and firmly – France, the United Kingdom, the United States, Sweden, Italy – are reeling like a punch-drunk, with their rates zigzagging on a monthly basis between better and worse, but always over larger time-units getting worse. And sadly, countries like little Panama where I live, tied hand and foot to the huge economic imperialist up north, and forced by political and economic pressure to adopt the same covid policy (if it can properly be called a policy) of the Great White Father, shows a similar month-by-month stagger, as the governments enforce curfews, masks, and social distancing, but then relax these rules under pressure from Big Money.
    Like the little kid who alone says the emperor is stark naked, Mary Beth bravely points out the politics- and mercantile-driven media insistence, including by censorship here on Basefook (I twist its name so I don’t get censored myself) – that dismiss certain early treatment regimens as "unverified" and "absurd", as falsehood because they are supposedly promoted by "fringe elements", and because they have been successfully adopted in (horrors!) countries other than the United States, which fools itself into thinking it is and must be #1 in absolutely everything. And this despite, for instance, a major medical journal, The Lancet, finally admitting one of its anti-early-treatment articles was founded on fraudulent data. And despite the fact, which Mary Beth has the guts to emphasize, that the rich and powerful – people like Boris Johnson, Donald Trump, Rudy Giuliani, Chris Christie, and Ben Carson survive because they get "immediate high-level treatment with costly experimental therapies. All while in Sweden, for instance, elderly people with coronavirus symptoms are sent home to die and their numbers left off the official count to make it look like Sweden is succeeding when it isn’t.
    Mary Beth carefully states in a related article on this website that "I don’t suggest there is a profit-driven conspiracy to let infections fester and people die."
    I, far less wise than she, DO think that, that profit is often chosen by policymakers over public health. Why else the zigzag between opening up businesses where the plague can spread and shutting them down so the plague doesn’t spread? Why else is the focus in countries like the United Kingdom and the United States – against one of the basic tenets of medicine – on cure rather than prevention? Mary Beth discusses the high safety of certain low-cost generic preventatives and early treatments that the U.S. government and media are literally blacking out of the public discussion. Instead, the government and media and Big Medicine are heavily promoting cure, which squeezes a lot more profit out of desperate dying patients, but results in their likelihood of survival being far lower than prevention and early treatment.
    While the media distract the public into focusing on Trump – who is certainly a big problem – they succeed further in distracting the public away from a much bigger problem, more than two million people dead worldwide, more than twenty-five million currently known to be infected — and way too many supposedly "advanced" societies seem to be eagerly throwing more people from the second category into the first.
    And the pun
    ch-line to this story is that Mary Beth tells me that she is unable to post her articles on her Facebook page because (to quote her) "FB is thwarting me". So I posted it on my own. And I hope you do too, and ask your friends to do the same. Public pressure on idiot policy-makers can and will make a big difference.

  5. There are even more studies showing benefit (also at all stages) from vitamin D as for ivermectin, and unlike ivermectin, vitamin D is known to essential for health. There is no ivermectin deficiency but roughly half of all people have too little vitamin D compared to the level recommended by the Endocrine Society (the foremost international scientific body on the subject). Vitamin D has an international letter with over 200 signatures (over 100 professors, over 100 medical doctors, over 100 PhDs) backing it from the group as well as a new French academic report with 73 authors and backed by 6 French national scientific societies. There was also an an Italian letter signed by over 60 Italian doctors and scientists. Even this has not changed official policy on vitamin D yet. Ivermectin needs letters like these with broad backing.
    Heads are going to roll in the pandemic post-mortem when all the evidence and dates it came out is carefully sifted through and the number of avoidable deaths from wrong-headed pandemic policy thinking gets computed.

  6. I agree. Medical research rarely points unambiguously in one direction. The procession of positive ivermectin trial results over the past couple of months should have been a "stop the presses" moment. The virtual silence of the media on this topic is a scandal on a scale we have never witnessed before.

  7. Also, one observation on the updated NIH recommendation. The full recommendation statement is:
    "The COVID-19 Treatment Guidelines Panel (the Panel) has determined that currently there are insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin for the treatment of COVID-19."
    There has been a lot of attention given to the first sentence of the recommendation with states that there is "insufficient data to recommend for or against…". That is generally a positive development since the previous recommendation was against the use of ivermectin. However, the recommendation begs the question,: Why did the panel consider the data on ivermectin to be insufficient for giving it’s full approval? The second sentence sheds light on that issue.
    The Panel provides an oddly detailed explanation of the CHARACTERISTICS of a clinical trial that could provide useful data. By this standard, the Panel should ignore 1000 clinical trials that all showed a benefit from the drug but each of which had minor methodological flaws.
    We need a more sophisticated standard for the evaluation of COVID-19 therapies. The current standard has the feel of bureaucracy more than science.

  8. One more point about the NIH recommendation. The statement is quoted in my earlier comment. The recommendation sets out the criteria for the study methodology with some specificity. Notably, however, it does not mention the criteria for the results themselves. For example, the panel might have addressed the issues of primary vs secondary endpoints, subjective vs objective endpoints, surrogate vs clinical endpoints, confidence levels etc. The NIH recommendation statement itself is odd.

  9. Lastly, with regards to the NIH recommendation. The most striking aspect to the recommendation is its passivity. The recommendation states "..adequately powered, well-designed, and well-conducted clinical trials are needed…" As it is phrased it makes the NIH, which is an agency with $42+ billion annual budget seem impotent.