By now you’ve probably seen mentions of the gastrointestinal side effects of ivermectin use, and probably had a good chuckle on the side. 

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One tweet in particular, which drew such juicy attention, reflected the “FLCCC Protocol”. Which raises the question, what the heck is that? A quick search pulls it up easily enough. It is the “Front Line Covid Critical Care Alliance” and digging through it shows a slickly produced website modeled after the CDC and other public health websites in style and content. (I won’t link because I don’t want to drive traffic)

There are links to legitimate discussions on the importance of gathering multiple lines of evidence and doing robust science. There are video blogs from doctors, for example, Dr Cadegiani appears to be a legitimate endocrinologist with links to Brazil and appears to have some published research. There are links to actual preprint articles, that check out as having links to actual journals. Granted, the abstracts for those articles clearly doesn’t support the claims that the website is making, but the articles do contain language that can be interpreted as suggesting that Ivermectin could be good for covid (in some fashion). 

Granted, there are some red and yellow flags on the website. The site has a link for resources on ‘where to get ivermectin’ on the front page, slipping that the website is basically a product shill. The doctor chat in the news feed has the doctors using a silly cartoon background that looks ripped right out of Blue’s Clues, and everyone in casual clothes. There is also a prominent discussion of censorship on the landing page. However, catching those red flags requires a certain type of trained skepticism. Depending on your frame of reference, these indicators could all seem normal. 

Whether any of the medical practitioners have been wrapped up in other quackery is beyond the scope my investigation.  The same is true for digging into whether the American Journal of Therapeutics sits on the spectrum from ‘gold standard in its niche’ to ‘second tier journal behind Lancet and Nature’ to ‘publication mill’.  The key point is that many aspects of the website pass the ‘does this look like a legitimate source?’ test, especially when you’re fact checking using google searches. 

I’d also like to point out that the website is targeting a particularly vulnerable population, and is a fairly tailored attack: 

1)  There is a nontrivial segment of the US population that has a nightmare time dealing with the medical establishment.  One easy example is overweight women of limited means. The intersection of fat-shaming, male-bias in medicine, and poverty sometimes block those folks from receiving competent care even when they go to the doctor.  Those folks get used to doing their own research as a matter of survival. 

2) The use of veterinary formulations for medicine isn’t that crazy. For those who don’t live near the us-mexico border and can’t afford to pay the premium to import medicines from Canada, you make do.  Veterinary medicines have the same active ingredients as human formulations, and are still subject to reasonable quality controls. Ivermectin is actually an interesting case, because it is very useful in topical formulations for head lice. However the human formulations in shampoo can run into the hundreds of dollars, while going to the local feed-n-seed is much cheaper.  Therefore this vulnerable population is probably already familiar with this particular drug. 

What I want you to take away from this diary is that Ivermectin isn’t some silly facebook meme people are buying into.  There is real discussion of the importance of science. Real world experience. Real doctors. Real journal articles. We’re dealing with a sophisticated disinformation campaign. 

People who have bought in may very well have read what are either real journal articles, or what they sincerely believe are real journal articles. Dismissing this as ‘guy in a truck’ youtube videos or ‘silly facebook memes’ will only insult people and be intensely counterproductive.

Understand that this isn’t stupidity. This is sophisticated disinformation. It will require a an equally concerted and sophisticated effort to stop. 

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This is a Creative Commons article. The original version of this article appeared here.

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