Ivermectin is a wondrous, Nobel Prize-winning drug that is cheap and available around the world.
The oral version — originally derived from a clump of Japanese dirt in the 1970s — has nearly eradicated infections that could otherwise have caused widespread blindness and disfigured people’s limbs and genitals. Formulated as a lotion, ivermectin is safe enough to be administered as an over-the-counter treatment for head lice in kids.
But ivermectin is not a miracle cure for COVID-19, and there’s no reason to think it could or should ever be treated as such.
Yet two men want you to think that ivermectin could be all we need to treat, or even prevent, any COVID-19 case: Dr. Pierre Kory, a former critical-care specialist at the University of Wisconsin medical center, and Dr. Paul Marik, the chief of critical care at Eastern Virginia Medical School.
Together, Kory and Marik lead the Front Line COVID-19 Critical Care Alliance, a nonprofit organization founded by fringe doctors and former media pros that has led an increasingly concerted campaign, hinged on twisted science, to promote ivermectin as a cure-all for COVID-19.
“Ivermectin is effectively a ‘miracle drug’ against COVID-19,” Kory told members of the Senate homeland-security committee last December, saying data showed “profound efficacy” of the drug “in all stages of the disease.”
He concluded that if everyone were to have access to the antiparasitic, “the pandemic will end, the economy can reopen, social interactions and activity can resume, and life can normalize.”
That is not true. But Kory and Marik, through the FLCCC, have led millions of people (including the podcast host Joe Rogan and many of his followers) to believe that hard data from around the world supports the treatment of COVID-19 with ivermectin. Some of it comes from studies that cite data that has been found not to exist. In other instances, they cherry-pick information or jump to conclusions about ivermectin’s role in ending illnesses in a way that makes ivermectin sound more effective against COVID-19 than it is.
The truth of this pandemic is that there is no single, surefire treatment for COVID-19 patients.
By suggesting that a prophylactic miracle alternative to vaccines exists, Kory, Marik, and the FLCCC are giving people false hope that can have grave consequences.
A once respected doctor whose hospital rejected his unsupported treatment ideas for COVID-19
Tom Williams/CQ-Roll Call via Getty Images
Kory, the president of the FLCCC, is a well-known doctor in the world of critical care, with nearly two decades of experience. He started his career in New York City, where he was instrumental in pioneering the use of bedside ultrasounds in his field.
Later, he spent more than five years working as a critical care and lung specialist at the University of Wisconsin’s teaching hospital.
“I love the enthusiasm of young doctors,” he told St. George’s University, his alma mater, in a March 2020 profile. “I am like ‘Dr. House’ followed by a large group of ducklings.”
Just one month later, the FLCCC was born. It started with an April 5 Zoom call among Marik, Kory, six other doctors, and two former journalists, Joyce Kamen and Betsy Ashton, who became the FLCCC’s press office. The group decided to call itself the Front Line COVID-19 Critical Care Consortium.
By April 15, the FLCCC was drafting press releases touting vitamin C, steroids, heparin, and hydroxychloroquine for COVID-19 treatment, and by May, the FLCCC says, it was sending its treatment protocols up to Jared Kushner at the White House.
Kory’s relationship with his university was beginning to fray. He grew increasingly frustrated with what he saw as the all-too-careful way his hospital was managing COVID-19 patient treatment.
“One of the reasons why I left my old institution is because they would not let me doctor, they would not let me use steroids, and they would not let me advocate for blood thinners,” Kory recently told a packed
Zoom
room marketed toward “the physicians and citizens of Malaysia.”
Both corticosteroids and blood thinners can, in some cases, help treat COVID-19 patients. But they aren’t by any means miracle cures for people with advanced disease. They’re part of a broad suite of treatments that doctors have cobbled together to help patients survive the illness. Nothing works perfectly.
The University of Wisconsin told Insider: “We offer many approved COVID-19 treatment options and have been a part of numerous clinical trials for both treatments and vaccines.” Those treatment options do not include ivermectin.
Kory left the University of Wisconsin in the summer of 2020 (UW declined to comment on why), then spent a few months working for Aurora Health Care in Milwaukee (Aurora also declined to comment for this story).
The protocols that Kory and the other doctors of the FLCCC have drawn up now call ivermectin “core” to the treatment of any COVID-19 case.
“I would say we are probably the foremost experts on the use of ivermectin in COVID in the world,” Kory told Rogan in June, describing himself and Marik.
“There’s no money to be made” in selling ivermectin, he promised. But the FLCCC does solicit donations from its followers through its website, and has an extensive online store full of ivermectin t-shirts, mugs, and fanny packs.
Others online do sell prescriptions for ivermectin, with some websites charging $90 per consultation.
Kory recommends a weekly dose of ivermectin to prevent COVID-19 infection.
“He paints himself as a savior, which then implies that every other doctor is not a savior,” Dr. Graham Walker, a San Francisco emergency physician who has treated COVID-19 cases and has been a vocal debunker of ivermectin misinformation online, said of Kory.
Kory recently got COVID-19 while taking the drug weekly.
“My case was pretty mild,” Kory said during an August FLCCC webinar, while still recovering. “I took treatment doses of ivermectin and I’m doing much better.”
A doctor who ostracized himself from mainstream medicine after his high-profile sepsis treatment was a dud
Jay Westcott/The Washington Post via Getty Images
Marik, originally from South Africa, is the other doctor heading up the FLCCC. He is less vocal in podcasts and on social media than Kory. But he and Kory appear to have agreed on an unproven treatment that touts cheap, widely available drugs as miracle solutions to complex illness before.
Marik presented the so-called Marik protocol in a 2017 edition of the journal Chest. At the time, other doctors were skeptical of his idea that a simple combination of the steroid hydrocortisone, vitamin C, and vitamin B1 (thiamine), could put an end to sepsis, which happens (often in older or immunocompromised adults) when otherwise innocuous infections turn deadly.
The Marik protocol was deemed useless after a large, global randomized controlled trial in 2020. It doesn’t work. But Marik had been so vocal about touting it that many patients and doctors around the world tried it out before it was properly debunked. Kory started his own clinical trial of the Marik protocol at the University of Wisconsin in 2019, a “retrospective chart review” that never posted results.
“Of course it doesn’t work,” Walker, the ER doctor, said. “All the ICU doctors I knew were like, ‘Ah, this does not make any sense — how does thiamine and vitamin C drop mortality?'”
Marik has also been reprimanded by the Virginia Board of Medicine for prescribing drugs to people who weren’t his patients. When Insider reached out to Eastern Virginia Medical School requesting an interview with Marik about his ivermectin recommendations at the FLCCC, a spokesperson said “Dr. Marik does not speak on this matter as a representative of EVMS and therefore we cannot assist you with this request.”
How doctors and former journalists joined ranks to campaign for ivermectin as a COVID-19 treatment
Paul Weaver/Sipa via AP Images
Marik and Kory first started chatting about ways to treat COVID-19 early in 2020, before the FLCCC existed. At that point, many doctors were desperate to brainstorm anything that might help save patients.
Marik touted his failed sepsis protocol as a possible treatment for COVID-19 as early as January 2020, according to the FLCCC‘s website. It later became the backbone of the FLCCC’s first iterations of COVID-19 treatment.
In October 2020, ivermectin became part of the group’s recommendations. The FLCCC initially described ivermectin as a “bridge” to vaccinations. But as time has gone on, what started as a place for doctors to discuss how to treat a poorly understood virus has morphed into a PR machine of sorts.
At high risk of COVID-19 complications? Take ivermectin weekly, Kory says.
Live with someone who contracted COVID-19? Also take ivermectin.
Dealing with long-haul COVID-19? Ivermectin is your answer.
“This is the beauty of this story,” Kory tells his followers on Odysee, a less-censored alternative to YouTube.
(While YouTube “doesn’t allow content that spreads medical misinformation,” Odysee’s community guidelines say the site doesn’t care what you publish “for the most part,” and has no rules against posting COVID-19 misinformation. Odysee has been embraced by Nazi extremists since it sprung up in 2020.)
“Not only it prevents, it treats early, it even saves lives in the hospital,” Kory says as he touts ivermectin on the platform.
As Marik and Kory drift further from the mainstream medical community, they’ve been sucked (willingly or not) into the embrace of the anti-vaccine far right. Ivermectin is now a darling drug of QAnon, and the FLCCC — in a move that looks similar to the QAnon playbook — is dismissing evidence that doesn’t fit its preconceived narrative.
The FLCCC, whether through Kory, Marik, or one of its other representatives, seems to thrive on villainizing the medical community. If a study shows ivermectin might not work, it must be because the scientists leading it are in the pocket of Big Pharma, they say.
Recent studies of ivermectin in peer-reviewed journals suggest that many of the studies that have been done on ivermectin so far (including some that Kory has co-authored) employ flawed and/or biased strategies for doing science.
An August 20 report in BMJ Evidence Based Medicine said only a minority of the ivermectin studies done so far are of high quality, and underscores there is still “important uncertainty” about whether the drug does anything for COVID-19 patients. But Kory calls that paper a “hit job,” by “naysayers.”
Betsy Ashton, a former consumer correspondent for CBS News who’s the creative director of the FLCCC alliance, led one of the organization’s recent weekly Zoom meetings, which highlighted the stories of people who’d lobbied (and sued) to get their family members treated with ivermectin in hospitals.
“You’ve certainly heard a lot in the press,” Ashton said of the recent wave of ivermectin stories, rolling her eyes on screen. “And it hasn’t all been accurate.”
Doctors may disagree about how to treat patients, and medicine is not one-size-fits-all, even during a pandemic. That doesn’t mean there’s a global conspiracy run by doctors, vaccine makers, and the media to shun ivermectin.
Susanna Priest, the editor in chief of the peer-reviewed journal Science Communication, says the way the FLCCC talks to the public is “inherently predatory, even if it’s not intended that way.”
There’s nothing wrong with having a “rogue opinion” in medicine, she says. After all, she adds, “that’s how scientific breakthroughs happen.”
But not everyone has the scientific training to assess the merit of the FLCCC claims with rigor and thoughtfulness.
“Many people don’t seem to understand how science works,” Priest told Insider. “What we have here is a conflict between our commitment to freedom of speech and a clash with the nature of scientific truth and people’s right to say anything they want.”
Studies and claims that fall apart under scrutiny
Phil Didion, USA Today Network via Reuters Connect
Researchers and journalists around the world have taken note of the glaring errors in and serious concerns about the data the FLCCC uses to promote ivermectin.
One small group of scientists has essentially made a mission of taking on the studies the FLCCC cites in a one-by-one fashion, exposing their inherent flaws. Among its members are the Australian epidemiologist Gideon Meyerowitz-Katz from the University of Wollongong and the independent data scientist Nick Brown in Spain. After being tipped off by a graduate student completing a school assignment, they found that one of the largest ivermectin studies yet (conducted in Egypt) used “data” that didn’t exist.
Another ivermectin study based in Argentina suggested the deworming pill might’ve prevented 100% of COVID-19 cases. That is, until a recent BuzzFeed News investigation revealed that at least some of the hospitals named in that study never participated.
“This would be an absolutely unheard-of level of efficacy,” Brown said, discussing the literature the FLCCC used to promote ivermectin. He pointed out that if the data to support ivermectin as a COVID-19 treatment were really as good as suggested by the touted studies, it’d be “better than antibiotics on bacteria.”
None of the larger, more controlled and sophisticated trials of ivermectin are finding evidence that the drug helps COVID-19 patients much.
“Very large benefits in the treatment of COVID are very unlikely,” Meyerowitz-Katz said. “It might help a bit — we don’t know if that’s true yet.”
Other doctors and public-health experts, whether they use ivermectin or not, generally agree with that. Ivermectin kills COVID-19 in lab petri dishes, but that doesn’t necessarily mean the same will be true in humans.
Ivermectin has been studied for many years in the lab, exhibiting properties in petri dishes that fight against a diverse array of viruses including flu, dengue, Zika virus, and HIV. But to date, it shows no major promise at fighting any of them off in the human immune system.
“It’s natural to be frustrated during the pandemic,” Dr. Adarsh Bhimraj, the chair of the Infectious Diseases Society of America’s COVID-19 treatment and management guidelines expert panel, said. “When emotions run high, it is hard to look at evidence critically, but this is precisely the time we have to be very critical about looking at the evidence the right way.”
Oxford University is investigating ivermectin as part of the world’s largest study of home treatments for COVID-19. (The principal investigator, Christopher Butler, said he’d be “delighted” to comment “once we have findings from our study.”)
It’s true that parts of the world (including in Brazil) use ivermectin to deworm COVID-19 patients when they arrive at hospitals, before they receive treatments like steroids. That is not because ivermectin treats COVID-19; it’s to prevent dangerous roundworm infections from going haywire.
What ivermectin does and doesn’t do
AP Photo/Mike Stewart, AP Photo/Ted Warren
There is no doctor working the front lines of this pandemic who doesn’t want a miracle cure for COVID-19.
It is still possible that ivermectin could (in the tablet form that is approved for use in humans) serve as one ingredient among a combination of medications that doctors might use to help treat COVID-19, especially in the early stages of disease. But that promise is far from certain.
What experts can definitively say is that ivermectin will never be a replacement for vaccination by preventing serious sickness and death.
In fact, millions of Brazilians already know ivermectin is not a miracle cure. Whole cities there, including Itajaí and Natal, were encouraged to take ivermectin to prevent COVID-19 earlier this year.
It was all part of Brazilian President Jair Bolsonaro’s unproven drug-kit strategy for COVID-19 treatment, which included hydroxychloroquine, ivermectin, azithromycin, as well as steroids and anticoagulants. The hype over these drugs was fanned by Dr. Flavio Cadegiani, who is a new member of the FLCCC (though he is better known for promoting another risky, unapproved and unproven drug).
“We Brazilians had to learn in the hardest way that ivermectin didn’t work,” Dr. Ana Carolina Antonio, who works at a government hospital in Porto Alegre, told Insider.
Antonio said that during the country’s second wave, about 70% of her patients were coming in having tried ivermectin already to prevent or treat COVID-19.
“I have already cared for many patients who took ivermectin and were still in the ICU for COVID-19,” she said. “I regret to say, most of those patients have died.”
One doctor who joined the FLCCC to research ivermectin says he left because the group became de facto anti-vaccine
The FLCCC is not vocally anti-vaccine, but by positioning ivermectin as a “miracle cure” without coming out with a full-throated endorsement of vaccines, the group has essentially set itself up as a touchstone for vaccine skeptics and opponents.
Before vaccines became widely available in the US, the FLCCC often called ivermectin a bridge to the day when vaccines would change the way we addressed COVID-19.
But that pro-vaccine language is now buried and watered down on the FLCCC’s website in an FAQ pull-down that says “our protocols are a bridge to vaccines and a safety net for those who cannot or have not been vaccinated” and ends with “the decision to get a vaccine should be made in consultation with your healthcare provider.”
Dr. Eric Osgood, a former FLCCC member, left the physicians’ group earlier this summer in a “panic,” he told Insider, after coming to the conclusion that “I’m part of a group whose influence may be contributing to people making the choice not to get vaccinated.”
Osgood has worked with the drug at the bedside over the past year and a half, and he does argue it could have some benefit for certain COVID-19 patients.
It might help prevent blood clots and improve oxygen levels in the body, acting as an anti-inflammatory, he said. If that is true, then ivermectin could be used in early treatment of COVID-19 but probably wouldn’t help with severe cases or in disease prevention.
Osgood said he felt like a frog in boiling water as the vaccines began coming out and the FLCCC failed to incorporate them into its recommendations. At first, he wasn’t terribly alarmed. But suddenly, he said, he had an “oh shit” moment, registering the effect the group was having on social media and the way its message was being received.
“If you’re going to have a page that’s dedicated to ‘How do you prevent yourself from getting COVID?’ that page can’t not have vaccines at the top of it,” he said, after leaving the group in August. “The main messaging that’s being put out by that organization is really coming mainly from a couple of doctors in leadership positions in that group, and the group’s media team.”
Osgood mentioned Kory and Marik, as well as Dr. Fred Wagshul, Kamen’s husband who’s been hauled to court after using ivermectin on a patient in Ohio without requesting his medical history.
The FLCCC, as well Kory, Marik, Wagshul, and Kamen, repeatedly declined Insider’s requests for comment for this story.
Giving people false hope has consequences
Mario Tama/Getty Images
Despite the dearth of good evidence on ivermectin, Kory, along with Marik and the media team at the FLCCC, continues lending credence to the idea that the compound merits widespread adoption.
“Is there a chance that ivermectin has an, I don’t know, 2%, 3% chance of doing something for people? Sure, there’s always a chance of that,” the San Francisco physician Walker said.
But for now, he cautions, “the data is just incredibly low-quality.”
Demand is now so high that FLCCC fans are asking one another how to get ivermectin from other countries, like India and Mexico. Others have turned to animal-grade ivermectin, so much so that the US Food and Drug Administration said on Twitter in August: “You are not a horse. You are not a cow, seriously, y’all. Stop it.”
Poison-control centers across the US have been flooded with calls from people suffering hallucinations, tremors, diarrhea, and nausea.
“Giving people hope in a therapy that is not developed whatsoever and pushing them away from things like vaccination, other therapeutics, public-health measures, it has its consequences,” Dr. Zain Chagla, an infectious-disease physician at St. Joe’s Hamilton who has pointed out errors in ivermectin studies, said.
“If we want to go through this pandemic and the future pandemics well, we have to build research networks that are able and agile enough and funded enough to actually get these answers quickly for outpatient use of treatment.”
The FLCCC largely ignores the benefits of vaccination, all while hundreds of unvaccinated American adults are dying every day from a disease for which we have vaccines that dramatically reduce the risk of death.
Priest says she doesn’t know “whether they stand to make money by it, or whether they simply believe it to be true,” but much of the FLCCC’s data on ivermectin is wrong, and the hype machine they’ve created is out of control.
At this point, Priest and other experts said, the FLCCC’s failure to acknowledge what they don’t know is discouraging vaccine uptake and promoting the false idea that COVID-19 is curable, prolonging the pandemic when the answers we need are already here.
“We don’t really have time for every false rumor to quiet down,” she said. “It doesn’t happen automatically.”
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