A health worker shows a box containing a bottle of Ivermectin, a medicine authorized by the National Institute for Food and Drug Surveillance (INVIMA) to treat patients with mild, asymptomatic or suspicious COVID-19, as part of a study of the Center for Paediatric Infectious Diseases Studies, in Cali, Colombia.LUIS ROBAYO | AFP | Getty ImagesWhen users visit the telemedicine website SpeakWithAnMD.com, they are immediately hit with a warning: “Due to overwhelming demand, we are experiencing longer than usual wait times.”The demand is for ivermectin, a drug primarily used to deworm animals that has become the latest false cure for Covid-19. And the website, in partnership with the organization America’s Frontline Doctors, whose founder stormed the U.S. Capitol on Jan. 6, has become well-known in the Facebook groups and Reddit communities where anti-vaccination sentiment thrives.In those groups, people trade dosing directions and purchasing advice for ivermectin.”Please consider that even if you can get an Rx for IVM, the pharmacy may not fill it for 1-3 days claiming they don’t have it in stock, which is pure bulls—,” a Reddit user wrote in the ivermectin community this month. “HAVE SOME HORSE PASTE ON HAND,” the user added, referring to the tube form that ivermectin meant for horses comes in.Originally introduced as a veterinary drug for livestock animals in the late-1970s, ivermectin quickly proved useful in combating certain human diseases caused by parasites, a discovery that won the Nobel Prize for medicine in 2015. It comes in pills and pastes, in versions meant for humans and for animals.Ivermectin has been called a “wonder drug” because of its use in treating parasitic diseases, but it has not shown the same results in studies against viruses.The drug was the subject of research into possible use as a Covid-19 treatment — including a promising non-peer-reviewed study that was later determined to be “flawed” and taken down by the website Research Square, which hosts preprints of research papers that have not yet been published in academic journals.The groups highlight the challenge public health officials and tech companies face in cracking down on Covid-19 misinformation — and the lengths some people will go to embrace fringe and misleading Covid advice. NBC News obtained access to several groups that are dedicated to ivermectin or have recently embraced the drug. Some groups have tens of thousands of members and can easily be found through Facebook’s search feature.More than a year and a half into the coronavirus pandemic, various drugs have had their moments in anti-vaccination communities and among some conservatives in the U.S — and ivermectin is not particularly different. But it comes at a time when parts of the country are in another Covid wave, this one fueled by the delta variant of the virus and with a safe and effective option available: the vaccines.”It’s hard to understand why people would turn down an FDA-approved Covid preventative in favor of a treatment that’s not only unapproved but has a large body of evidence showing it doesn’t work,” said Dr. Nathan Boonstra, a pediatrician at Blank Children’s Hospital in Des Moines, Iowa, and co-host of the podcast “Voices for Vaccines.” “But antivax groups will eat up any opportunity to make it seem like a vaccine isn’t needed. This has been true about anti-vaccine groups long before the pandemic.”There is a lot of shared space between pro-ivermectin and anti-vaccine groups,” he added.The Centers for Disease Control and Prevention issued a health advisory Thursday warning of a rapid increase in ivermectin prescriptions and reports of severe illness by people using ivermectin products. Data from the National Prescription Audit showed a dramatic spike in ivermectin prescriptions in recent weeks — more than nine times pre-pandemic levels.Facebook spokesperson Aaron Simpson said in an emailed statement that the company removes any content that “attempts to buy, sell, donate or ask for Ivermectin.””We also enforce against any account or group that violates our COVID-19 and vaccine policies, including claims that Ivermectin is a guaranteed cure or guaranteed prevention, and we don’t allow ads promoting Ivermectin as a treatment for COVID-19,” he wrote. “Since the beginning of the pandemic, we have removed 20 million pieces of COVID misinformation, labeled more than 190 million pieces of COVID content rated by our fact-checking partners, and connected over 2 billion people with authoritative information through tools like our COVID information center.”Reddit is reviewing the ivermectin communities, spokesperson Cameron Njaa said in an emailed statement that underscored its commitment to providing accurate information, resources and support to its users. The groups suggest ways to buy ivermectin and plenty of encouragement to do so. Some commenters push users to online cattle supply companies or pet stores. Others recommend SpeakWithAnMD.com. The website advertises consultations for $90 and fills prescriptions through Ravkoo Pharmacy, an online pharmacy that America’s Frontline Doctors advertises as “partners,” who provide “the option to have that prescription delivered right to your door, the same day.” On a SpeakWithAnMD.com intake form viewed by NBC News, prospective patients are asked, “What medication do you prefer?” The user is then presented with three options: “Ivermectin,” “Hydroxychloroquine” or “Not sure.”A user visiting for other reasons may not have much luck. The website makes it clear: “Controlled substances (such as narcotics) will never be prescribed.”Reached by phone, Ravkoo Pharmacy CEO Alpesh Patel declined to comment about the relationship with America’s Frontline Doctors and hung up. America’s Frontline Doctors and SpeakWithAnMD did not respond to requests for comment.From hydroxychloroquine to ivermectinMuch as the anti-malaria drug hydroxychloroquine became an unproven remedy for Covid deniers after former President Donald Trump embraced it, ivermectin has emerged in recent weeks as a favorite treatment of some conservatives and anti-vaccination activists.Ivermectin first drew some attention late last year as a possible Covid treatment, with interest remaining reasonably low until July, according to Google search data.In recent weeks, a variety of conservative figures and anti-vaccination activists have embraced the drug. Fox News hosts Laura Ingraham, Sean Hannity and Tucker Carlson have mentioned it.Phil Valentine, the conservative radio host who died from Covid-19 this week, also turned to ivermectin after his diagnosis and urged his listeners to do the same. (He later encouraged listeners to get vaccinated.)”Have a doctor on speed dial who will write you a prescription for ivermectin,” he wrote on Facebook. Public health officials have scrambled to respond.While ivermectin is generally safe in low doses, high doses can be toxic in humans. The Food and Drug Administration warned that ivermectin in large doses can cause side effects including “skin rash, nausea, vomiting, diarrhea, stomach pain, facial or limb swelling, neurologic adverse events, sudden drop in blood pressure, severe skin rash potentially requiring hospitalization and liver injury.”The State Health Department in Mississippi, where at least two people had been hospitalized for ivermectin toxicity, warned residents against taking the medicine this week. And in perhaps a prime example of the exhaustion with which some public health professionals have confronted ivermectin, the FDA recently tweeted: “You are not a horse. You are not a cow. Seriously, y’all. Stop it.”‘Moo juice’The warnings have done little to stunt enthusiasm for ivermectin in some Facebook groups and Reddit communities. After self-medicating, some community members report back to the group with side effects, like gastrointestinal upset or dizziness, or wonder whether they have overdosed.The link to the SpeakWithAnMD website has been shared in dozens of public Facebook groups, including Unmask Our Kids, Nevada! It has also been shared by prominent anti-vaccination influencers, including Dr. Christiane Northrup, who posted the link to her 550,000 followers on Facebook with the caption: “To get the right treatment or prevention. No need for fear. Many of us have known this all along.”America’s Frontline Doctors is not SpeakWithAnMD’s only link to the far right. Conspiracy theorist Jerome Corsi also provides his audience with a vanity link to the website, which was created in March 2020 and offers no information about its ownership. SpeakWithAnMD is closely tied with America’s Frontline Doctors, a group that went viral last year when its makeshift news conference in Washington got millions of views after one of the physicians, Dr. Stella Immanuel, falsely called hydroxychloroquine a “cure” for Covid-19. Trump retweeted a video of the news conference pushed on social media by the conservative media site Breitbart.The website for America’s Frontline Doctors directs people to SpeakWithAnMd through a button that reads “Contact A Physician,” and the America’s Frontline Doctors logo is prominent on the SpeakWithAnMD homepage.Simone Gold, founder of America’s Frontline Doctors, was arrested and charged with violent entry and disorderly conduct after she entered the Capitol during the riot on Jan. 6. She pleaded not guilty to all charges. Gold, who is awaiting trial, spoke at an anti-vaccination protest in Santa Monica, California, last weekend. Gold has spent the last year barnstorming churches, schools and event spaces throughout the U.S. on “The Uncensored Truth Tour,” in which she gives a presentation sowing doubt about Covid vaccines.Gold did not respond to requests for comment.The popularity of the site has sent some Facebook users back to the feed store. Losing patience with SpeakWithAnMD’s wait times, users on Facebook’s ivermectin groups sometimes share anecdotes about other telemedicine apps on which doctors have prescribed the drug prophylactically, or they try to persuade one another to buy it over the counter at pet stores.The Facebook groups, which have names like Ivermectin MD Team, lead some users to believe they are talking to medical experts and doctors, but any one of the 25,000 members can post advice or suggestions about taking the deworming drug.The communities are filled with advice for off-label drug cocktails featuring the dewormer. The pages frequently feature ways to make the paste more palatable, such as mixing it with jellies or eating it as a sandwich. The flavor frequently has users wondering how to hide its pungent taste.”I take it by hiding it in a banana or bread,” a Reddit user wrote. “The flavor sort of bothers me.”Some users sell what they claim to be ivermectin in the comments sections. Desperate for what they believe is a miracle drug, commenters frequently oblige, often leaving their WhatsApp addresses or phone numbers in replies to complete transactions.Worried about crackdowns due to increasingly bad publicity, moderators of the Facebook groups are also creating backup channels on smaller social media channels, like MeWe and Telegram, in case they are banned from Facebook. Users have also cut back on the use of the words “vaccine” and “ivermectin,” calling them “v” and “ivm,” respectively. Some users have begun to call ivermectin more colloquial names, like Moo Juice, because many have been ingesting the gel version. Others ask users how much their “horse” weighs when they dole out advice for dosages.”I identify as a horse and can report no ill effects from the directed dosage as recommended by professionals, taken on a weekly basis,” a Reddit user wrote. “I like mine with a side of strawberry jam.”
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