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The formal proof is finally there: Ivermectin reduces COVID-19 mortality by 4-11 times
By using the latest results from a huge study, we have gained valuable real-world evidence and we are finally able to formally prove that an ivermectin-based protocol reduces the risk of death for symptomatic cases by 4-11 times.submitted by massimaux to ivermectin
The first retrospective observational study with 3,099 patients
Several days ago there has been published a pre-print report from the first huge study on the effects of ivermectin treatment at two medical centers in the Dominican Republic on symptomatic patients in outpatient and inpatient settings. This retrospective observational study included 3,099 patients with a definitive or probable diagnosis of COVID-19 conducted between May 1 and August 10. In the following we will give a brief overview of the method, protocol and results.
A total of 3,099 patients were evaluated, diagnosed and treated at two medical centers in the Dominican Republic:
Those with mild symptoms were treated on an outpatient basis and were given ivermectin at a single dose of 0.4 mg/kg, and azithromycin 500 mg daily for 5 days, with further follow-up.
The hospitalized patients received ivermectin at a dose of 0.3 mg/kg on day 1 and 2, and the dose was repeated on day 6 and 7. They also received azithromycin 500mg daily for a period of 7 days.
Hospitalization rate and hospital fatality rate
Why is this study important for the world in general? Because the model and protocol used in this study quantifies the impact of an ivermectin-based therapy on two basic parameters on which the mortality rate directly depends:
Symptomatic versus confirmed cases
First of all, we need to recall that when talking about COVID-19 positive cases, one considers all cases confirmed by positive PCR tests. For this analysis, it is crucial to understand that confirmed cases include both symptomatic and asymptomatic cases. According to a systematic literature review, asymptomatic people account for 40-45% of the total number of confirmed cases. In this analysis, we will assume that the percentage of asymptomatic cases is 40%. Hence, this represents 67% (40/60*100) of the number of symptomatic cases. So, the following applies:
Confirmed positive cases = symptomatic cases + asymptomatic cases
Confirmed positive cases = 1.67 * symptomatic cases
Why is this important? In the Dominican Republic study, there were no asymptomatic cases at all. Namely, all patients were clinically diagnosed with COVID-19, which means only symptomatic patients were considered.
On the other hand, the basic statistical parameter calculated for each country and the world in general, is the confirmed case fatality rate (CFR). But CFR also includes asymptomatic confirmed cases, and we know that there are no fatalities among them. Only symptomatic cases can result in death. Hence, the case fatality rate (sCFR) is a much more relevant statistical parameter as it focuses only on symptomatic patients with COVID-19. Therefore, in the following text, we will focus and operate with this parameter.
Let us now determine the hospitalization rate (HR) and the hospital fatality rate (HFR) in the Dominican study. What do we need?
Number of symptomatic cases: 3099
Number of hospitalized patients: 411
Number of deaths: 37
HR(IVM) - hospitalization rate for ivermectin-treated patients
HFR(IVM) – hospital fatality rate for ivermectin-treated patients
HR(IVM) = (number of hospitalized patients) / (number of symptomatic cases)
HR(IVM) = 411/3099 = 13.3%
HFR(IVM) = (number of deaths) / (number of hospitalized patients)
HFR(IVM) = 37/411 = 9%
You are already guessing, the next step is to quantify HR and HFR for symptomatic cases in the world and to compare those with the respective values from the Dominican study.
The hospitalization rate of positive cases, according to the WHO, is estimated at around 20%. According to U.S. CDC report covering the period January-May, 14% of all reported cases were hospitalized. Given this information, we will assume that the HR of confirmed cases is in the range 15-20%.
However, we need HR only for symptomatic cases. Given the above assumption that the number of positive confirmed cases is 1.67 times greater than the number of symptomatic cases, the HR for symptomatic cases would be 1.67 times higher than the HR for confirmed positive cases. Hence, it follows that:
HR(symptomatic) = 1.67 * (15 ÷ 20)% = (25 ÷ 33)%
Hospital fatality rate (HFR)? According to a German study, the mortality rate among inpatients is around 22%. According to another US study, HFR is about 25%. So, we take that HFR is in the range of 20 ÷ 25%.
Ivermectin reduced both rates
Indeed, if we compare the rates, we get:
HR(IVM) = 13.3% → 2 to 2.5 times less than the world HR (25 ÷ 33)%
HFR(IVM) = 9% → 2 to 3 times less than the world HFR (20 ÷ 25)%
Ivermectin reduces both hospitalization rate by 2 to 2.5 times and the hospital fatality rate by 2 to 3 times. This is a great benefit that no other drug or treatment has ever demonstrated.
What about the case fatality rate of symptomatic cases?
The total world case fatality rate (CFR) in the period of the Dominican study (May 1 – August 10) was 3%. The symptomatic case fatality rate (sCFR) will be obtained by multiplying the CFR by a factor of 1.67 to get rid of asymptomatic cases (which do not affect mortality):
sCFR = 1.67 * CFR = 1.67 * 3% = 5%
On the other hand, CFR is a product of HR and HFR, so for patients from the Dominican study we get:
CFR(IVM) = HR(IVM) * HFR (IVM) = 13.3% * 9% = 1.2%
Finally, if we compare sCFR and CFR(IVM), the ratio is greater than 4. The conclusion is obvious. If Ivermectin-based therapy is administered worldwide according to the protocol in the Dominican study, one could have a reduction in mortality of COVID-19 by at least 4 times. Imagine how many lives would be saved by implementing such a strategy!
But is the protocol described in the Dominican study optimal?
There is a better protocol
Note that in the Dominican protocol, patients were treated with ivermectin (and azithromycin) only after seeking help themselves.
Indeed, those with mild symptoms sought medical attention and received treatment on average 3.6 days after the symptom onset. Having mild symptoms and seeking help in time, they were heavily protected, with only one death out of 2706 mild cases.
Those who developed moderate symptoms sought medical help on average 6.9 days after the symptom onset. Because they sought help at a time when some of them had already developed a cytokine storm, 1% of them died.
Those who developed severe to critical illness sought medical help on average 7.8 days after the symptom onset. Because they were already in a severe or critical condition and many of them had developed severe cytokine storms, the mortality rate in this subgroup reached 30%.
Obviously, the protocol was not optimal. It would have been much better for all patients if they were diagnosed on time within the first few days after the onset of symptoms. Why? It is well established in several studies, and as Dr. Marik explained, in the first 7 days from the onset of symptoms, the patient is in the symptomatic stage. During this stage virus is still replicating although slowing down and only antiviral drugs can help stop the virus from replicating and prevent a cytokine storm. If the virus is not neutralized within the first 7 days, some patients progress to a dangerous pulmonary/inflammatory stage with a devastating cytokine storm that can kill its own host.
So, the key to dealing with COVID-19 is receiving antiviral therapy in the first few days of symptoms, or early treatment. Ivermectin is an anti-parasitic drug with proven broad-spectrum antiviral properties, and increasing number of studies are proving it to be very effective against COVID-19.
Dr. Tarek Alam’s protocol
According to the clinical data provided by Dr. Tarek Alam, the clinician who first started ivermectin + doxycycline therapy in May, with which he has treated thousands of patients, the hospitalization rate for symptomatic cases ranges from 2% to 5% if started in the first 5 days from the onset of symptoms. If we take the higher value as more cautious and conservative, and use the in-hospital fatality rate from the Dominican study, we would get:
HR(IVM) = 5% → 5 to 6 times less than the world (25 ÷ 33)%
HFR(IVM) = 9% → 2 to 3 times less than the world (20 ÷ 25)%
sCFR(IVM) = 5% * 9% = 0.45% → 11 times less than world's sCFR = 5%
We conclude that a hypothetical implementation of early treatment with ivermectin worldwide, one would have a reduction in mortality of 11 times and 5 to 6 times reduction in the number of hospitalized patients.
The following graphs visualize previous numerical results.
Of course, the Dominican study is just one of the many positive studies on ivermectin against COVID-19. Let us review some of them.
Prophylaxis studies with ivermectin against covid-19
In a randomized controlled trial with a control group, the closest members of already infected cases received two doses of ivermectin (post-exposure prophylaxis) within three days. In the ivermectin-treated group, 7% got infected, while 58% of those untreated got infected. The risk of infection was reduced by 8 times.
In another randomized study, health workers in several hospitals were divided into a treatment and a control group. The treated group received ivermectin in oral drops and nasal spray of iota carrageenan regularly. In the control group there were 11% infected, while among the treated no one got infected. Then, they extended this protocol to a larger number of health workers in 4 hospitals. The result is fantastic. None of the 788 treated health professionals got infected, while the infection rate in the group of 407 untreated was 58%.
In the latest prophylaxis study published in the beginning of November, a 73% reduction in the risk of infection was observed in health care workers who received two doses of ivermectin within 3 days.
Ivermectin treatment studies against COVID-19
We will review only three representative studies that demonstrate the effectiveness of ivermectin in all phases of covid-19.
In the last randomized, double-blind, placebo-controlled study with a fairly large statistical sample (183 + 180), patients with mild to moderate illness treated with a combination of ivermectin and doxycycline had faster recovery, a much smaller percentage had clinical deterioration, with faster viral clearance and no one died. In the placebo group, three patients died.
In another relevant study, 115 patients received ivermectin and 133 were in the control group. In the ivermectin group, disease progression occurred in only 2% of patients, while this percentage in the control group was 15%. All other parameters were superior to the control group, including mortality which was 1% in the ivermectin group and 7% in the control group.
A retrospective non-randomized study was performed at several Florida hospitals during March, April, and May. Mortality in the ivermectin-treated group was 15%, while mortality in the control group was 25% resulting in 40% reduction. More importantly, in a subgroup of severely and critically ill patients there was a reduction in mortality of 52% (from 80% to 39%). By comparison, a similar result was found in the Dominican study, where 30% of the severely to critically ill died. This is a proof that ivermectin not only has strong antiviral properties, but can also calm the cytokine storm due to its immunomodulatory and anti-inflammatory properties.
How does ivermectin fight against covid-19?
Ivermectin has long been proven to have broad-spectrum antiviral potential. Several recent papers theorize how ivermectin fights against COVID-19. There are at least three possible mechanisms of action:
1. It prevents virus replication
So far there have been several molecular studies (so-called in silico studies because they are based on computer modeling and simulations). According to one theory, SARS-CoV-2 has a so-called spike protein by which it attaches to the ACE2 receptor and enters a cell cytoplasm where it replicates. According to the study, there is solid evidence that the ivermectin molecule binds to the spike protein and virtually prevents it from attaching to the ACE2 receptor. Since the virus cannot enter the cell, it cannot replicate.
2. It prevents the viral protein from entering the cell nucleus
This is the most commonly cited mechanism in the literature. Normally, the SARS-CoV-2 protein is translocated into the cell nucleus using its importin-α (IMP-α) and importin-β (IMP-β) heterodimer. Once in the nucleus, the SARS-CoV-2 protein is released from the IMP-α / β complex. This protein turns off the alarm system that normally triggers the first line of defense: interferon production and natural killer cells (according to Dr. Marik's lecture). According to this mechanism, when the virus is already in the cytoplasm, the ivermectin molecule destabilizes the importin alpha / beta complex and the virus is prevented from releasing protein into the nucleus. In this way, ivermectin helps the first line of defense, i.e. allows the innate immune system to fight the virus.
3. Anti-inflammatory and immunomodulatory properties
When the cytokine storm starts, it is too late to kill the virus, because it is already dead. But ivermectin has also been shown to regulate the immune system and reduces the production of inflammatory cytokines. In fact, its effectiveness in the early and late pulmonary/inflammatory phase has been empirically proven in a study in the United States, a study in Argentina, and a study in Iraq.
Ivermectin in protocols for prophylaxis, early treatment and hospital care
Although it is still not receiving the attention it deserves globally for inexplicable reasons, many physicians and clinical centers have already included ivermectin in their treatment and prophylaxis protocols. One such global initiative is the Front Line COVID-19 Critical Care Alliance (FLCCC) which is a group of renowned critical care specialists with over 1000 medical publications. The FLCCC is led by Dr. Paul Marik, Head of Pulmonary Medicine and Critical Care, Eastern Virginia Medical School, Virginia, USA. This group has generated two protocols in which ivermectin plays a key role:
I-MASK +: protocol for prophylaxis and early outpatient treatment
MATH +: hospital treatment protocol
We hope that ivermectin will finally display on the radar of mainstream health authorities who will recognize the numerous positive results from various clinical studies and include it in the protocols for prophylaxis, early outpatient treatment and hospital treatment.
Ah, I almost forgot. Many are concerned about how safe ivermectin is, or whether it causes dangerous side effects. There is no reason to be concerned. Ivermectin is one of the safest drugs on the planet. In the last three decades, it has been prescribed in at least 3.7 billion doses worldwide. Doses approved for use do not cause side effects. But you don’t need to have blind faith, just have a look at this and this study, and you will see for yourself.
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“Yay..what if we get killed”
My aunt said the same thing
Lol I was pumped so i just laughed...I was trying to get her into it. For Randonautica, before you start you have to concentrate on an intention. Putting out energy into the universe...manifesting whatever your intention is. Which we laughed at...but we did it because if something is worth doing, it’s worth doing right. One of the only lessons I remember from my dad...the other was when I was 16 I kinda robbed a place I used to work at...just some punk kids doing stupid shit...change really...and too young and ignorant and privileged enough to not fully understand how much of a shithead thing it was. I got caught and my dad had to drive me to the police station. On the way he says “no matter what happens to you, don’t rat out your friends ”. Those 2 lessons have stuck with me through life Now, a lot of people do negative intentions just because of the stories you find on the internet about them. Death and Satan and shit. But I said our intention would be positive. It would be wealth. Not just money...wealth..something that would better our lives and bring genuine happiness. So we set off hyper like when we were in high school. We’ve been friends since we were 16...best friends. No matter how long it has been, there has never been a time where we see each other and we don’t get insta happy. We’re talking and I said wealth reminds me of high school, when we would skip school and drive out to the model homes...acting like we’re interested in buying...even though we were obviously high school students. We’d buy a couple disposable cameras and take pictures in all the rooms, pretending we lived there and just loving life...and we did that quite a few times. But we got talking about that and saying it’s be hilarious if it brought us to model homes. we drive up....and the destination was beside a creek behind the backyard fence line of a row of houses. Model homes and houses under construction. We were freaking. So we leave the vehicle...and usually it wouldn’t matter but my friend...I’ll call her PAS.... was driving her moms vehicle. I start filming and shit, my phones at like 45% and hers was at %30 so we have enough battery for the trip. PAS was really paro about the vehicle but I laughed and said it’s directly across the street from construction workers and in a really nice neighborhood and not to worry. we set off. We walk down the street about 100 meters and realize the route it’s trying to take us directly cuts through a house..so we had to find our way around. We found a path between 2 houses that lead us behind the fence line. There’s a pond, and a creek. The path follows along the creek and cuts off and ends abruptly on a treen line. No more paths, just bush and big bare trees. It’s super cold out, but we’re halfway through a huge joint and have a couple large timmies so we were fine. We trudge through bush and we see a dip down and almost a doorway...leading into the forest down a slope about 7 feet down. We’re filming, and PAS says “my phone just died” and at the same time, my phone dies. We look at them and they both just have the apple symbol. It was freaky..lol. The whole time I’ve been hyping us up but it got freaky. We felt an energy. It was crazy and amazing and honest. I felt 16 again. So we hesitate, but carry on. Now I’m old. I feel old. I act old. I haven’t gone missioning through bushes and thick forest in years. I used to love going on random adventures through creeks and trees and bushes. And we just made a path. We break through the line of trees and come upon this giant gnarly beautiful tree that has these giant branches forking off at the base. The branches are probably 60 inches around. One blocks the way to the left, but our destination was on the other side of that tree. The brNch forking to the right hung low to the ground, but there was just enough room that we slid under...like we were 16 again. I’m climbing down the slope and Amanda screams. I turn around and she’s staring up at this giant white and grey owl. It takes off startled. She was so pumped about that owl...the rest of the day pales in comparison to how happy she was seeing her first owl. I’ve never seen her so excited about something. Lol. It was sweet and beautiful and real. So we’re down...under what looks like a dome. The forest is bare, but it’s a ring of trees with the branches reaching over it, about 8 feet at the highest point of the “ceiling”. Probably 60 feet around...a circle of trees creating a beautiful dome. We were so happy and excited and calm at the same time. There was a dog barking in the distance, and we could here the creek is about 10 feet away. It felt so tranquil, and happy and real. There was a giant mound of compost, which to me can connect to wealth if you think about it. Outside the circle in the distance I see a White mound. Looks almost like a bag...so we take off through thick bush to get there..maybe we found our wealth. We had so much energy and excitement. We get to the white mound and we realize it’s just a bleach bottle with no label. Lol. Just behind it was a log with a can of pop sitting on it upright. It looked like someone had left it just then. I laughed and said “we probably just scared off some serial killer. “ Now this whole time, we couldn’t record it because our phones had shut off. Which sucks. Because it was beautiful. And retelling it sounds nuts. So we decide to head back. We get back out to the street and PAS mentions again we better hurry cause she doesn’t feel safe where we left the vehicle...and I laugh at her telling her she’s being silly. We look down the street and beside the car is a dude peering into the windows. So we took off running. And then started walking again 10 feet later cause we’re old. All of a sudden we’re bother aware we’re freezing. absolutely freezing. The whole hour we were missioning through the forest we weren’t cold once. We power walk toward the car and the guy seems to disappear behind it. We get up to it and he has turned around and is coming back the direction we’re coming. He crosses the street and he looks freaky. He has a hood tied tight around his head. Probably Middle aged, with big sunglasses on this overcast day. We get back to the vehicle and it’s the first time I realize we’re parked at a fork in the road, and in the grass of the fork is a giant fucking jet, propped up...at the entrance to airport property. I thought it was crazy that I hadn’t noticed this giant jet when we parked facing it and comment that I’d be horrible in a war. So we get in and I spill my coffee. We’re all excited and talking about all the crazy things, most of which I can’t remember. We laugh and freak cause it’s her moms car...so I pull out a napkin from my pocket, soak up the coffe, and toss the napkin out...only because the side of the road we were on was dirt and grass and it was just a tiny biodegradable napkin. I laugh and say “now my dna is at the scene”...(cause of the coffee I was drinking) so if that guy ends up being a killer it will be only my dna hanging around. We laugh and drive off. As we turn around and pull off we see a cop go by. We keep driving and see a dead cat. Which is sad and freaky. And DIRECTLY across the street was a church with a huge sign that said “Jesus is alive” we laugh nervously at the irony. We’re driving and I realize I have weed in my pocket...so I reach in to grab it, I brought it for her and I realize it was wrapped in the napkin I had just used to clean up the coffee and threw out the window. I hadn’t left just my dna behind, but my weed too. Instant karma for being an asshole and littering anyways. So we loop back for it. We got back and it was still there with the weed still in it. parked facing it is a cop. Lol. I wouldn’t be surprised if someone called the cops cause we were so excited and loud. And we had gone trough the forest right behind all these huge new beautiful homes. And we came out running cause that guy was at the car so we prolly looked sus af. We leave, wondering what to do next. So we decide to go get my haircut. My hair has been a big secret stress trigger for me cause whenever I go to get it cut I start thinking about the 10 years I’d spent growing it and the fact that at my age if I cut it I’ll probably never be able to grow it back...and it causes major anxiety and I chicken out and end up with “just a little off the sides, don’t touch the top” But we were filled with this brave energy that had us feeling like every positive thing and goal we were thinking about would come to fruition...that was how real this experience had felt...and I thought cutting off my hair is just cutting off 10 years of a lot of intense trauma...and I should just move forward with this new motivation, and having my best friend there sealed the deal, so we went to the salon. On our way we detoured past an old house of hers...which was nice...when we hang out we have 8 million memories that make us laugh. We got there and I realized I didn’t have a mask. “Don’t worry, my mom prepares for EVERYTHING, check that bag in the back” It’s like a soft thermal tote bag with a zipper, and sure enough it had hand wipes, hand sanitizer and a pack of 100 blue masks. We laugh cause that’s so her mom. So she waits in the car, cause of covid, and I hesitantly enter the store...cause of covid...and she says I can sit down. So I do. I’m all hyper, still crazy excited about the magic I had just felt...and I told the 2 woman that were there all about it. Stumbling through the story. And I realized how stupid it sounded. It sounded so fake. “Then we found this dome of trees. And our phones turned off at the same time...and there was a giant owl, all white and grey. And a guy creeping at out vehicle, and a dead cat...but it felt so real and magical” Lol I looked and sounded like a nut job. Like I was making it all up. Lol. They were just nodding, being polite. We hadn’t even started my hair yet. So I told them about the anxiety I felt over getting it cut. So she combs it out, grabs some and says “ready?” “Ya, I just wish my friend could be here to see my hair get cut” it sounded silly but it was a huge moment for me “She can come in, there’s only the 2 of us...as long as she has a mask, sanitizes her hands and distances it’s fine” So I jump up with the smock and run outside and bring her in. And she starts relaying the story...we start reliving it..l Now she’s telling the same story I was telling...so I didn’t look like a nut anymore lol. I felt validated, and they believed her. Lol. My aunt is my best friend and is just 1 of the many amazing women I have had in my life. PAS, my grandma, my mom, my 7 sisters. My brother. Vivian..Ive been wealthy with love. And although I wanted to shed the 10 years of hair and move forward from the trauma, I wouldn’t change a single second of it. Because I’m lucky to be so wealthy. Side note...sorry if I sound like a rambling idiot. I had to get it all out before I start forgetting it. I have a 30 ban on Facebook, got zucced...and didn’t have photos of the last half of it, so I had to write it all down.
to those who have read this far. I hope you have some sort of happiness that you can hold forever.