William Bird is director of Media Monitoring Africa (MMA).

One of the common trends over the past few weeks have been complaints about Ivermectin. It has been touted as a miracle drug, to cure Covid-19, or as an effective preventative tool to be taken prophylactically. Some complaints relate to content suggesting that it should be used with a range of other over-the-counter medications from vitamins and antihistamines to lemon juice and hot water. There is even a business publication that has decided that not only is it a revolutionary drug but those opposing it are somehow denying our freedoms and are pushing a big pharma oppressive anti-democratic government agenda. Yes, a business publication. 

The problem, of course, is that as far as we can tell the jury is still out on Ivermectin. There appears to be some anecdotal evidence of its efficacy, but it certainly hasn’t been deemed to be safe. Readers may be aware that earlier this year there was a court case, the outcome of which was that Ivermectin can be prescribed in certain cases. This piece sets out the issues really well and is an important read. While that was in April, and while our medicine regulatory body Sahpra’s last statement seems to have also been around the same time the interest in it seems, based on the complaints we have received, to be increasing. 

What we know is that the evidence for its efficacy in treating Covid-19 is still pretty slim. This GroundUp piece in News24 from 5 July goes so far as to state, “there is now little doubt that this is not a wonder drug; whatever benefits it may have are at most modest”. To be clear, we are not suggesting we know about whether it works or not, nor are we suggesting that it shouldn’t be further investigated, discussed and debated. What is a real problem is when it is touted as something it is not. Like a used car sales agent telling you for R15,000 you can buy a Ferrari because it has the badge and is red. It might well be a car but it isn’t likely a Ferrari, or one that works. The way some are pushing Ivermectin isn’t just in a “sounds too good to be true” – we should know it likely isn’t true kind of way, they are also frequently denying any logical counter. Frequently they deny rational evidence and perhaps most disturbingly, they also tend to be anti-vaccine.

At this point the tips are: if a person tells you Ivermectin works and offers only anecdotal evidence, be sceptical; if they then also tell you not to take vaccines don’t believe it at all – not because we say so but just because there is no logical connection of the efficacy of Ivermectin and vaccines. It’s like saying, “here eat these new green plants they are good for you but don’t eat mielies”. Aside from that reason the evidence – yes proof – vaccines work is overwhelming and a simple internet search of credible sources will demonstrate that.

The challenge, however, is that the disinformation about Ivermectin is often, on the surface, persuasive. Let’s look at an example. 

The content of the post was the subject of this complaint.

The first question to ask when assessing content is whether the person allegedly making the statements is real. A simple search reveals that indeed the doctor referred to in this complaint does exist, her rooms and office details are easily found, as are the details of her medical qualifications on the Health Professions Council site. There is nothing to suggest that the doctor had not made the comment or that her account was hacked as there are no denials. It seems then that not only is the person who made the post a doctor but that they also made the comments.

That the person is real and a doctor immediately heightens the disinformation stakes. A consistent message in the pandemic has been to trust the science and the medical experts. Further, given the critical role that doctors and healthcare workers have played, and continue to play, it is not surprising that healthcare workers rank as the most trusted professions. According to US research, nurses are the most trusted with medical doctors following close behind. Any of us that go to a doctor put our lives in their hands, we trust them with our loved ones and ourselves, and usually when they tell us things we tend to believe them. So when we see a real doctor telling us about a drug and dissuading us from another it seems more than reasonable to believe them. On a basic level then we have a seemingly credible expert sharing information with us. The information is made all the more compelling by the arguments she makes.

To add to it, the comment seeks to add further credibility to the claims, by suggesting that the reason she discourages people from being vaccinated is to ensure they “make informed decisions”. She then goes on to say:

By openly reaffirming her commitments to the Hippocratic Oath she is adding weight to her claims and commitment to the health of her patients. She then adds and encourages responsible sharing of fact-based information. Drawing on her authority as a doctor, she then tells us she is looking after the patients’ interests and sharing responsible information. So, the setup is of the doctor directly encouraging us to believe and trust her. She goes on: 

Again, in telling us about the research, she is telling us to trust because not only is she caring for the patient and sharing responsible information, but she has done research and used reliable sources of data. Unfortunately for the doctor, this is where it all starts to fall apart. No links or references to the reliable sources are made, no names for the case studies she has studied are provided. While it was clear we were talking about the Covid-19 vaccine above, there is a rather cryptic, “checks on the after effects of the Covid-19 injection [not a vaccine].” It’s not clear if she is claiming the vaccine isn’t a vaccine but something else, this is likely the case, or whether she is referring to some other injectable treatment – possibly Ivermectin – but that is extremely likely as later on she refers to the “positive result gained from using Ivermectin”. Offering none of the evidence, the doctor has swiftly moved from encouraging informed views to denial that the Covid-19 vaccine is a vaccine. Ignoring for the moment that there are many actual Covid-19 vaccines that have been tested and approved, her assertions of why we should trust her come down to a blanket denial that the vaccine is actually a vaccine. But it gets worse.

Suddenly we move from a vaccine that isn’t a vaccine to how the number of deaths and side effects of it are overwhelming. As the doctor should know, adverse effects have to be reported so she should be able to give us the numbers then of these overwhelming deaths and side effects. Looking at the USA where they have vaccinated around 158 million people, they also reveal details of those who have had adverse effects here. They offer this: 

“More than 331 million doses of Covid-19 vaccines were administered in the United States from December 14, 2020, through July 6, 2021. During this time, VAERS [Vaccine Adverse Event Reporting System] received 5,946 reports of death [0.0018%] among people who received a Covid-19 vaccine. FDA requires healthcare providers to report any death after Covid-19 vaccination to VAERS, even if it’s unclear whether the vaccine was the cause. Reports of adverse events to VAERS following vaccination, including deaths, do not necessarily mean that a vaccine caused a health problem.” 

In other words even if you take the full number it is really, really, small 0,0018%. So quite where the “deaths are overwhelming” from the vaccine are coming from is perhaps confused with those who are actually dying from Covid-19. Sadly, she is just repeating common disinformation as debunked here. The one person the doctor refers to as a source is Dr Geert Vanden Bossche. He, too, is real, but his comments taken to heart by the doctor have been widely fact checked and dismissed, here, here and here. In a wonderful display of false logic she ends her non evidenced-based paragraph of disinformation by saying she doesn’t force her opinion on her patients and wants them to make an informed decision. Yet the doctor offers no evidence for her claims let alone any of the widely available evidence that runs contrary to her claims.

And then we get to Ivermectin.

It seems perhaps previously the doctor has shared some links, and then cites the Journal of Antibiotics. The journal is again real and is seemingly credible. There are seemingly two studies in the journal, here and here. In the first article the conclusion from the abstract is: “In vivo studies of animal models revealed a broad range of antiviral effects of Ivermectin, however, clinical trials are necessary to appraise the potential efficacy of Ivermectin in clinical settings.” In effect it means we need more clinical trials. And in the second article, published on 15 June, the mechanisms of action of Ivermectin against SARS-CoV-2: An evidence-based clinical review article, there is a note saying: “22 June 2021 Editor’s Note: Readers are alerted that the conclusions of this paper are subject to criticisms that are being considered by the editors and the publisher. A further editorial response will follow the resolution of these issues.” In other words it shouldn’t be taken as true. So quite where the positive evidence is coming from is not clear. The doctor then finishes up the piece with an anecdotal claim that the response of patients using Ivermectin has been more positive than negative. Like the used car agent saying, Ferraris run like a dream. It might be, but we don’t know which or how many patients etc. The doctor ends the statement implying that people, possibly journalists, could contact her and some of her patients if they gave consent to share their experiences. While anecdotal evidence has some value it cannot be the basis for deciding on the safety and efficacy of a drug where the evidence isn’t clear.

Overall, at first glance the statement has much to lend itself credibility and fact, it comes from a real doctor and various devices are used to encourage the reader to believe the assertions. Closer examination however reveals that what little evidence is presented cannot be trusted and the doctor uses her status to disseminate common disinformation. To those who don’t check the link or read it carefully, or to those who may wish to be seen as bucking the “government line” or challenging “big pharma” the statement may be persuasive. The example shows how disinformation can be disguised as credible. There is another question however, which is, is it ok for a medical practitioner who claims to live up to the standards of the Hippocratic Oath to push disinformation? To be clear, this doctor is one of a handful doing similar things. What role for the Health Professions Council, should they and or the National Department of Health seek action against such doctors?

This example of disinformation shows just how complex the challenge of promoting disinformation can be, and why when consuming information and viewing content online (and any information for that matter), it needs to be done so critically and with caution. There is a lot of content out there circulating our social media platforms that may relate to, be deemed as, or blatantly include several digital harms. It is critical that we all play our part in combating and mitigating these digital offences. If you suspect that content you come across could potentially be disinformation, hate speech, harassment of journalists or incitement to violence, there is something you can do about it. You can report it to Real411. 

To make it even more simple, download the Real411 mobile app. Again, we take this chance to also remind you: We are approaching that magical period where political parties need to show us that they care, so in addition to asking about what they will do in your area, ask them to issue one public statement a month in the lead up to elections that highlights and condemns any attacks on our journalists AND then to demonstrate what action they took to help combat that. If they are edgy or push some other bullshit agenda don’t vote for them because they don’t believe in democracy. DM/MC

Remember, if you come across content on social media that could potentially be disinformation, report it to Real411.