News is circulating online that Haruo Ozaki, president of the Tokyo Medical Association, is recommending the use of ivermectin for the treatment of covid-19, as there is currently no better or proven effective treatment for the disease. Specifically, a twitter user posted a tweet celebrating a supposed recommendation by Ozaki to take ivermectin to treat covid-19, but it is MISLEADING. Yes, Haruo Ozaki, the president of this association, does not entirely discount the potential benefits against covid-19 of taking ivermectin, but he has not approved anything, nor does he have the power to make policy decisions in the country, nor is this the official position of the Japanese government.
"Tokyo Medical Association president conducts live press conference recommending #ivermectin to all the doctors, for all covid patients. The Japanese Government is one of the most conservative and cautious in the world. Data is clear. Great news"
Last 23 August, a tweet went viral in which a user claimed that Haruo Ozaki, president of the Tokyo Medical Association, had recommended ivermectin for patients with covid-19, accompanied by a video of the press conference in which the announcement was supposedly made. As of 13 September, the tweet has had more than 16,800 'likes' and more than 10,400 retweets. This message has also been posted on other Twitter accounts and on various websites directly stating that Japan has approved the use of ivermectin.
However, in the press conference Ozaki says nothing of the kind: the expert makes a brief argument in favour of administering this antiparasitic to covid-19 patients - "Regarding the use of ivermectin, obviously it is necessary to get informed consent from the patients, and I think we are in a situation where we can afford to give them this treatment" - but he also makes it clear that the figures he gives - "In Africa, [. ...] if we look at the numbers of covid in countries that give ivermectin (to treat other diseases), the number of cases is 134.4 per 100,000 and the number of deaths is 2.2 per 100,000. In African countries that do not distribute ivermectin, we have 950.0 cases per 100,000 and 29.3 deaths per 100,000 population" - are not sufficient to conclude that ivermectin is effective.
Ivermectin is a broad-spectrum antiparasitic used to treat onchocerciasis (river blindness), strongyloidiasis and other geohelminthiases, as well as scabies. It is included in the WHO list of essential drugs as a treatment for several parasitic diseases. In January it was also approved in South Africa as a treatment on compassionate grounds in a controlled access programme, but it strongly discourages its use beyond these established margins. In fact, ivermectin has not been approved for use as a treatment against covid-19 in any country in the world outside clinical trials.
Japan does not approve the use of ivermectin
On the other hand, what the Tokyo Medical Association has made is a recommendation, but the position of the Japanese Ministry of Health is diametrically opposed: as Agence France Presse, official guidelines state that "compared to standard treatment and placebo, ivermectin did not reduce deaths, shorten the period of hospitalisation and improve the time to disappearance of the virus".
Consistent with these findings is the most recent review by the Cochrane library, a non-profit scientific organisation dedicated to publishing systematic reviews conducted by experts to draw conclusions about a particular topic. In the case of ivermectin, a ureview came out on 28 July in which experts concluded that "based on the current evidence of very low to low certainty, there is no certainty about the efficacy and safety of ivermectin used to treat or prevent covid-19. Completed studies are small and few are considered to be of high quality".
The question, however, is not closed: "Several studies are being performed that may produce clearer answers in review updates".
Without enough evidence in favour of the drug
This antiparasitic was proposed at the start of the pandemic as a treatment because of its antiviral effect; scientists suspected it could prevent the replication of SARS-CoV-2, as it has been shown to do for dengue, zika, and yellow fever viruses. Some studies, such as this one in JAMA, or this one in The Lancet, have noted that it could have a potential therapeutic effect. However, as ISGlobal explains in a special dossier on the subject, "several groups have conducted reviews based on published and unpublished data", resulting in "contradictory messages that cause confusion among the general public, fuel conspiracy theories, and sometimes lead to contradictory recommendations and statements by political and health authorities".
Therefore, to date and after more than a year and a half of analysis and clinical trials, there still does not seem to be conclusive data: "The European Medicines Agency (EMA) has issued a statement advising against ivermectin, both for the prevention of severe disease and for treatment in clinical practice, and has asked that it continue to be used in the context of clinical trials," Judit Villar, assistant physician at the Infectious Diseases Service and head of the International Health Unit at the Hospital del Mar (Barcelona), concludes to Verificat.