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The good news is that today, a million doses of the Astra-Zeneca COVID-19 vaccine arrive at OR Tambo International Airport.

The bad news is that at least 44 164 South Africans have already succumbed to COVID-19, among them many healthcare workers, and the likely death toll is far, far higher.

South Africa’s failure to act rapidly on the vaccine front, coupled with a healthcare system pushed beyond breaking point, has led to the use of Ivermectin being widely touted.

Adverts have done the rounds on WhatsApp, with videos purporting to show rapid recovery in patients suffering from COVID-19, and last week, the South African Health Products Regulatory Authority (SAHPRA) announced that it would “facilitate a controlled compassionate access programme” to Ivermectin for use for patients with COVID-19.

Ivermectin is usually sold in South Africa for treatment of animals under brand names like Ivomec, Ivotan, and Ivermite, but regular supply chains have reported being sold out.

This past weekend, six people were arrested at OR Tambo International Airport for smuggling suspected Ivermectin tablets estimated to be worth around R6 million.

For those considering the use of Ivermectin, Prof Vinny Naidoo, the dean of the University of Pretoria’s faculty of veterinary science, and a specialist in veterinary pharmacology, has a few words of advice.

He penned an in-depth article on TimesLIVE, unpacking it all, but here’s how that starts:

Since the release of the first articles on the potential effectiveness of ivermectin, there have been several questions on the use of the cattle drug in people, since it is available over the counter as a veterinary drug.

The simple answer is no, don’t use it; it is illegal to use a veterinary drug or stock remedy on people. The compassionate use of ivermectin approved by the SA Health Products Regulatory Authority is still limited to only the medical drug, and will need approval by the Sahpra through its section 21 process.

Naidoo breaks things down step-by-step, concluding that “it is very unlikely that ivermectin would be effective in a person”.

With regards to the clinical studies that have shown positive results, he argues that they have been small sample sizes, those conducting the studies may have been influenced by information they were exposed to, and that some patients in the study were also given other drugs.

Naidoo concludes as follows:

This is why when used, the patients need to be under the care of a doctor to allow for proper patient monitoring. While some might argue the benefits surely outweigh the risks, this is not a true reflection of the situation and, until proper clinical studies are completed, the public should in no way be misled into saying that drinking the veterinary ivermectin formulation will be a panacea in this pandemic.

Health24 also spoke with Naidoo, and another veterinary expert, about the use of Ivermectin, and what can go wrong if it’s not properly administered.

As The Daily Maverick points out, around the world, caution is the order of the day:

The World Health Organisation, America’s Food and Drug Administration, the European Medicines Agency, Australia’s Therapeutic Goods Administration and the UK’s Medicines and Healthcare Products Regulatory Agency, after having reviewed the data have all decided not to authorise ivermectin for Covid-19 – either for prevention or treatment – until more data is available.

Ultimately, SAHPRA’s decision to allow controlled compassionate access puts many of our doctors in a tricky position:

Some doctors are justifiably desperate for new means to treat patients in the face of devastatingly high caseloads. There is virtually no recourse for them, especially without the assurance of enough doses of vaccines for the general population. They have argued that, faced with high Covid-19 caseloads and the highly transmissible variant in South Africa, we cannot wait for the data on large double-blinded, randomised placebo-controlled trials and that in the meantime ivermectin is a risk worth taking.

Other doctors, probably the majority as far as we can tell, feel they want to be guided by the “best science” and will only change their minds on prescribing ivermectin when robust evidence is available. These doctors will most likely not apply for access to ivermectin for their patients.

The jury is very much still out on this one.

[sources:timeslive&dailymav]