The Mexico City government has become engulfed in scandal due to its distribution of the anti-parasitic drug ivermectin to people who tested positive for COVID-19, its alleged completion of an unauthorized study on the medication’s efficacy and its publication of a paper detailing its supposed benefits.
The government spent just under 29.3 million pesos (US $1.4 million) to buy 293,000 boxes of the drug – usually used to treat conditions caused by intestinal parasites, head lice, scabies and other skin infections – as well as significant quantities of aspirin and azithromycin, an antibiotic.
The medications are not approved by the federal government or the World Health Organization for the treatment of COVID but the administration led by Mayor Claudia Sheinbaum nevertheless distributed them to some 200,000 people who tested positive, according to an investigation by the news website Animal Político.
The drugs were distributed in medical kits handed out at Mexico City testing stations starting in December 2020. They continued to be distributed until September 2021.
The Mexico City government as well as the federally-run Mexican Social Security Institute (IMSS) announced last year that they had carried out a “quasi experimental” analysis that found that people who received the ivermectin distributed in the capital were 68% less likely to develop serious symptoms that required treatment in hospital.
“… The medical kit was a significant factor in the reduction of hospital admissions and of course possible deaths,” José Antonio Peña Merino, the head of the Mexico City government’s Digital Agency for Public Innovation (ADIP), said in May 2021.
Peña, Mexico City Health Minister Olivia López and other officials co-authored a paper detailing the results of the analysis that was published on the website SocArXic, which describes itself as an open archive of the social sciences.
Ivermectin and the odds of hospitalization due to COVID-19: evidence from a quasi-experimental analysis based on a public intervention in Mexico City was downloaded more than 11,000 times and was among SocArXic’s “most-read papers of the past year,” the website’s director, American sociologist Philip N. Cohen, said in a statement last Friday.
He announced that SocArXiv’s steering committee had decided to withdraw the paper due to various concerns about it, among which was that it was “spreading misinformation [and] promoting an unproved medical treatment in the midst of a global pandemic.”
Cohen noted that SocArXiv had previously written about the paper, saying that “depending on which critique you prefer, the paper is either very poor quality or else deliberately false and misleading.”
He said the paper had received more attention as the result of a report published by Animal Político last Tuesday.
“In response, University of California-San Diego sociology professor Juan Pablo Pardo-Guerra posted an appeal to SocArXiv asking us to remove the ‘deeply problematic and unethical’ paper and ban its authors from our platform. The appeal, in a widely shared Twitter thread, argued that the authors, through their agency dispensing the medication, unethically recruited experimental subjects, apparently without informed consent, and thus the study is an unethical study; they did not declare a conflict of interest, although they are employees of agencies that carried out the policy,” Cohen wrote.
“… It is clear from the record of authoritative statements by global and national public health agencies that, at present, ivermectin should not be used as a treatment or preventative for COVID-19 outside of carefully controlled clinical studies, which this clearly was not,” he said.
Experts who spoke with the newspaper El Universal said the Mexico City government should offer a public apology for distributing ivermectin and completing an unauthorized study. One doctor asserted that the officials responsible should resign.
Omar Yaxmehen Bello Chavolla, a medical researcher and academic at the National Autonomous University, stressed that ivermectin has not been approved for the treatment of COVID-19. He noted that there are studies that suggest that a very high dosage of the drug could work against COVID, but such doses are toxic.
“There’s a lot of misinformation around, and you may have heard that it’s OK to take large doses of ivermectin. It is not OK,” the United States Food and Drug Administration says on its website.
From an ethical point of view, the government’s actions “left a lot to be desired,” Bello said, noting that there is no evidence that the people who received the medical kits were informed they would be part of a study.
“What we would expect is [for the government] to say: ‘We recant from this publication and are aware of the ethical implications; the case will be reviewed to define responsibilities …,’” he said.
Carlos Sanders-Velez, a medical doctor and scientist, said everyone involved in the ivermectin saga should resign immediately given that it may have caused harm. It’s a medication that can cause serious adverse effects, he said.
Xavier Tello, a health policy analyst, said the distribution of a drug not approved for treating COVID is “one of the biggest mistakes” the Mexico City government has made.
The Mexico City Health Ministry (Sedesa) defended the distribution of ivermectin to ambulatory COVID-19 patients, issuing a statement on Saturday that said the medication is “safe, cheap [and] without adverse effects in controlled quantities.”
“This medication is approved in the country. It has been used to treat a range of parasite infections and other diseases with a lot of success. … [The distribution of ivermectin to COVID-19 patients] was not an experiment as some media outlets have deceitfully [said],” the ministry said.
Sedesa said it stopped distributing the drug in September after the federal government published a COVID clinical guide advising against its use.
IMSS – a federal agency – also said the use of ivermectin in Mexico City was not part of an experiment. It said the drug can be beneficial to COVID patients and the risk in using it is “practically non-existent.”
Via a statement issued by its medical benefits division, the agency reiterated the findings of the paper published on SocArXic, saying that the use of ivermectin – as well as its strategy of monitoring COVID patients being treated at home – reduced the need for people to be admitted to hospital.
“The medication was included in [medical] kits for ambulatory patients prior to medical evaluation and with complementary instructions … and monitoring of symptoms via telephone. At no time were experiments undertaken,” IMSS said.
“… The use of ivermectin was recommended in patients with a diagnosis of mild or moderate … pneumonia,” it said.
“… The recommendation came from a group of expert pulmonologists and infectious disease doctors who took into account the stage of the pandemic, which had claimed the lives of many Mexicans,” IMSS said.
“The vaccination program was only just beginning, for which reason its use was considered in the face of an emergency health situation, taking into account the lack, at that time, of any treatment with proven efficacy,” it said.
President López Obrador and Deputy Health Minister Hugo López-Gatell – the government’s coronavirus czar – weighed in on the controversy on Tuesday, with both men defending the Mexico City government.
The former said the journalistic investigation was part of a “campaign of attacks” on the government run by “the conservative bloc and its mouthpieces.”
“… Two magazines that received money from the previous government are involved, … one is Nexos and the other is Animal Político,” López Obrador said.
López-Gatell echoed the claim that no ivermectin experiment was undertaken and asserted there had been a persistent distortion of the truth with regard to the matter. “There was no experiment as many media outlets say,” he declared.