Doctors who touted ivermectin as covid fix now pushing it for flu, RSV

First, the group of doctors championed ivermectin as a covid panacea. It failed to live up to the hype. Now, they're promoting the anti-parasitic to prevent and treat the flu and RSV.

The Front Line Covid-19 Critical Care Alliance, formed in 2020 to "prevent and treat covid," is touting ivermectin for common respiratory infections amid a dramatic drop in prescriptions for the drug as clinical trials undermined claims of its efficacy against covid.

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There is no clinical data in humans to support using ivermectin for flu or RSV, according to the Centers for Disease Control and Prevention and other medical experts.

And yet, the alliance publishes "treatment protocols" promoting the use of ivermectin for flu, RSV and covid that it says have been downloaded more than a million times. It also recommends a network of hundreds of medical providers and pharmacies that can provide prescriptions for ivermectin, often through virtual visits that can run hundreds of dollars.

"Profiting from bunk and nonsense has no place in ethical medicine," said Arthur Caplan, head of the division of medical ethics at the New York University Grossman School of Medicine who called the alliance's promotion of ivermectin for covid, flu and RSV "fraud during a pandemic on a significant scale."

The alliance's co-founders Pierre Kory, a Wisconsin critical care doctor, and Paul Marik, whose medical license expired in 2022 according to Virginia licensing records, declined through the alliance's spokesman to be interviewed. Marik said through the spokesman that he chose not to renew his license.

Kory responded over email, through the spokesman, to questions about the group recommending ivermectin for flu and RSV despite the lack of scientific evidence and accusations of profiteering from medical misinformation.

"Ivermectin has been found to have strong antiviral properties and is effective as part of a protocol that includes other medications and supplements," Kory said in a written statement.

He said doctors and medical scientists associated with the alliance began exploring how "covid-like" respiratory infections "might respond to novel treatments" and developed the protocol for RSV and flu "using medical and scientific research (including over 80 references to peer reviewed studies) as well as clinical data from doctors currently treating patients."

But the CDC and other medical experts strongly advise against such protocols.

"Ivermectin is not recommended by CDC for prevention or treatment of influenza, and there are no data from clinical trials of ivermectin for prevention or treatment of influenza in people," CDC spokeswoman Kristen Nordlund said. "It's important to note that currently, ivermectin has not been proven as a way to prevent or treat RSV."

The CDC has warned that ivermectin, commonly taken as a pill, can interact with medications such as blood thinners and that overdosing on ivermectin can result in gastrointestinal symptoms and neurological effects.

Nordlund also noted that the alliance itself points out on its website that there is "no (published) clinical data on the use of ivermectin in the treatment of influenza."

While the CDC can refute the alliance's claims, the agency does not regulate free speech - or doctors' licenses. It has been rare for medical boards to discipline doctors for spreading misinformation, even as groups like the alliance gained influence during the coronavirus pandemic and helped shape the health decisions made by many Americans.

Studies the alliance points to as supporting the use of ivermectin for RSV and flu were conducted in test tubes, which means their conclusions have not been tested in humans, medical experts say.

"If you threw Coca-Cola into cell culture, you would see an antiviral effect. But you wouldn't want to be squirting Coca-Cola up your nose against the flu and RSV," said John P. Moore, a professor of microbiology and immunology at Weill Cornell Medical College.

The alliance gained national prominence in December 2020 when Sen. Ron Johnson (R-Wis.) invited Kory to a hearing on early covid treatments, and Kory's comments promoting ivermectin as a "miracle" drug went viral. Powered by conservative voices, ivermectin became a flash point in the ongoing covid culture wars, with many Republican legislators and officials pushing to protect access to the drug. The nonprofit alliance received nearly $5 million in donations in 2021 as its platforms grew increasingly influential.

At its height in August 2021, the group's website drew more than 1.4 million unique visitors in one month; traffic to the site has since dropped nearly 80 percent to just over 300,000 unique visitors in January of this year, according to SimilarWeb, a digital analytics firm.

Amid the decline, the alliance in November 2022 began expanding beyond its covid-focused mission to develop new treatment protocols for flu and RSV as those cases inundated American hospitals. "There was growing confusion and uncertainty about diagnosing and treating RSV and influenza given how similar the symptoms of both infections are to COVID-19," Kory said in his statement to The Washington Post.

The alliance's website includes a disclaimer that its recommendations should not substitute for medical advice. Low-risk RSV patients should not take ivermectin for treatment, the website says, and taking ivermectin preventively should be reserved for those who are immunocompromised, have multiple medical conditions or are traveling to high-risk events such as weddings and conferences.

When Alison Lafferty, a 48-year-old church bookkeeper in Yakima County, Wash., saw Kory's tweet about the new RSV and flu protocol in November, she had been sick with a respiratory ailment for 12 days and said she eagerly shared the alliance's recommendations with her networks. Lafferty, who has chronic Lyme disease and supports alternative treatments, credited ivermectin for making her feel better when she got covid in 2020. She and her husband continue to take ivermectin to ward off further infections, she said.

"You should be able to walk into your local Rite Aid or Walgreens and get ivermectin if you need it," said Lafferty, whose Twitter profile proclaims "IVERMECTIN SAVES LIVES."

Ivermectin, while approved by the Food and Drug Administration to treat some parasitic infections, head lice and skin conditions such as rosacea, has not been shown to be effective against covid, according to several clinical trials - including ones published in the New England Journal of Medicine and the Journal of the American Medical Association.

Merck, a pharmaceutical company that manufactures ivermectin, has said there is "no scientific basis" and "no meaningful evidence" to prescribe the drug for covid - a rare public step given that drug companies typically do not weigh in on "off-label" prescriptions by doctors.

When asked about the promotion of ivermectin for the flu and RSV, Merck spokesperson Julie Cunningham said "our company statement remains the same: The use of ivermectin is not supported beyond the doses and populations indicated in the regulatory agency-approved prescribing information."

As scientific studies emerged showing the ineffectiveness of ivermectin against covid, ivermectin prescriptions fell by more than 85 percent from their height in August 2021 to December 2022, according to data from IQVIA, a health care information and consulting company.

Eric Osgood, a New Jersey-based physician who had worked as an adviser for the Front Line Covid-19 Critical Care Alliance, told The Post he parted ways with the group in 2021 after it doubled down on ivermectin.

Osgood said he's not surprised the group is expanding its recommendations to other diseases.

"They obviously want to stay relevant," he said. "RSV and flu is a way to keep at it with whatever is coming down."

The alliance's physicians and medical scientists, Kory said, are "constantly looking for ways their expertise in treatment protocols can be helpful to the medical community."

Osgood said the alliance had initially formed to find stopgap treatments for covid amid the chaos of the pandemic's early days. Old records of the group's website show it used to promote masking as a way to protect against the coronavirus, but that language has been stripped away as it backed ivermectin.

"There are thousands of people making decisions not to protect themselves based on what the group is telling people," Osgood said.

Kory disputed Osgood's characterization: "To say that ivermectin causes harm is to show a great deal of ignorance of ivermectin's 40-plus year safety record."

Other doctors say they worry adhering to the alliance's protocols prevents sick people from seeking proven treatments that could benefit them.

"I wouldn't want to see faith in such regimens keeping people from getting the care they need," said Jesse Goodman, director of the Center on Medical Product Access, Safety and Stewardship and professor of medicine at Georgetown University Medical Center.

The alliance discourages followers from taking Tamiflu, widely prescribed by doctors to treat the flu, because of its accusation of "fraud, deception, and abuse perpetrated by Big Pharma and the federal agencies." Doctors stress that while that drug is not perfect, medical studies support Tamiflu's efficacy in shortening symptoms and reducing the likelihood of hospitalization in higher risk patients as well as its overall safety.

Alliance leaders have faced disciplinary threats to their medical credentials.

The American Board of Internal Medicine has warned that doctors who spread medical misinformation could jeopardize their certification and sent letters to Kory and Marik last year, according to the alliance's website. Losing certification would make it much harder to practice medicine at large hospitals and academic institutions, physicians say. The board would not comment on Kory's or Marik's cases, but their certification remains current, according to the board's public database. Kory told The Post both he and Marik expect to retain their certifications.

Fred Wagshul, a pulmonologist and a founding member listed on the alliance's website, was notified by the Ohio medical board last year that his license is at risk for prescribing ivermectin to a patient on a ventilator without examining him or obtaining his hospital records, according to a state medical board letter. Wagshul has not responded to The Post's attempts to reach him.

Mary Talley Bowden, an ear, nose and throat specialist listed by the alliance as a clinical adviser, has publicly stated that she is facing complaints that could jeopardize her medical license. A judge recently dismissed her $25 million defamation lawsuit against a Houston hospital that tweeted she was "spreading dangerous information which is not based in science" following her public comments on ivermectin and vaccines.

Bowden said in an email to The Post that she intends to appeal the ruling.

Kory and Marik, along with the alliance, stand to gain from their view on ivermectin. The alliance's tax records show it received $4.9 million in donations in 2021.

Kory was paid more than $231,000 and Marik made $50,000 from their positions with the alliance, according to the group's 2021 tax records. Presales of Kory's upcoming book, "The War on Ivermectin" (distributed by Simon & Schuster), have already landed it among the top 10 in several Amazon science categories.

Kory promotes his telehealth clinic over Twitter, where his following tops 320,000. He is not listed as a provider on the alliance's website because he said "founding members and clinical advisers believe it is a conflict of interest to use their place on the FLCCC website to drive potential patients to their respective medical practices."

But the provider list did include Bowden, and showed her charging $130 for a telehealth appointment. After an inquiry from The Post, Bowden said her inclusion was an "oversight" she had asked to correct; the site no longer lists her as a provider.

Some of Kory's telemedicine appointments, where long-covid sufferers can receive prescriptions for ivermectin, cost $1,650 for a video consultation and two follow-ups. His subscription-based newsletter on substack, "Pierre Kory's Medical Musings," boasts thousands of subscribers who pay between $6.50 a month to $200 a year to access some of his writings.

On top of paying up to a few hundred dollars for a telehealth visit, it would cost more than $500 to buy all the medications and supplements recommended by the alliance's prevention and treatment protocols for the flu and RSV, according to a Post review of prices.

The alliance noted on its website that it promotes ivermectin as a much cheaper alternative to nitazoxanide, another anti-parasitic, to treat flu and RSV because the preferred drug can be prohibitively expensive in the United States.

"The protocols are developed with trying to balance the quality of the supplements recommended with cost," Kory told The Post. "We want the protocols to be accessible to all income levels."

Annie Luetkemeyer, an infectious-disease doctor at University of California at San Francisco, said she worries about the financial and opportunity costs of taking all the drugs and supplements recommended by the alliance that, in her expertise, would not do much - and could even cause harm.

"I can see why people are hungry for this," she said. "But there are substantial safety concerns about interventions that haven't been studied and are given in combination with a lot of other medications."

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