FOR the next phase of fighting this scourge of the Covid-19 pandemic, our decision makers must think outside the box. This requires looking beyond the scientific information fed and channelled through mainstream corridors to other paths less travelled.

I have written a few articles arguing that the vaccine strategy should not be stand-alone. Ivermectin, a high dose of vitamin C, boosting the innate immune system of people through a healthy diet and supplementation must be additional strategies to complement the vaccine strategy.

Current circumstances demand that concurrent strategies be used to contain the epidemic. This includes a rising infection rate and our hospitals coming close to maximum capacity.

Of primary concern is the issue of immune escape. It has been reported that there are now thirty Covid-19 variants of concern in our country that includes the South African variant, B.1.351, which a scientific report concluded might not only escape the mRNA vaccines but render those vaccinated more susceptible.

The study of Kustin et al (2021) pre-printed in medRxiv, “Evidence for increased breakthrough rates of SARS-CoV-2 variants of concern in BNT162b2 mRNA vaccinated individuals”, showed the B.1.351 variant’s prevalence rate was 5.4% for those who had two doses of the vaccine versus 0.7% for those unvaccinated.

Infection of the variant was eight times higher for the vaccinated, and was also more transmissible.

Moreover, there are uncertainties regarding long-term effects, especially with vaccines using mRNA technology; the possibility of an auto-immune cascade, of interference of genetic material and a gradual alteration of DNA and triggering of abnormal cells.

Data on animal studies are absent, which adds to the concern, and there is also concern on fertility.

On a positive note, the future of mRNA technology has vast potential in developing cures for cancer, stroke, and diseases of genetic disorder. But science must develop at a small pace and cannot be rushed. 

The decision makers in our health ministry must be conscientious when seeking scientific information to be eventually used as evidence-based medicine or therapy.

The cyberspace has lots of junk masquerading as science – studies that are highly biased, flawed in design, reviews based on unreliable data, studies sponsored and funded by vested interest groups to cast aspersion on a rival medication, and non-disclosure of financial links to study sponsor.

The case of hydroxychloroquine, the controversial potential treatment for Covid-19 is a good example.

In mid-2020, the malaria drug hydroxychloroquine made headlines as promising against the coronavirus and drove sales up. This was quickly followed by two badly designed, short-duration studies that used flawed data from analytics company, Surgispher.

One study showed Covid-19 patients treated with the drug did not experience a lower risk of death compared to patients receiving other treatments. The other study showed that cancer patients with Covid-19 receiving the hydroxychloroquine and azithromycin had a risk of death 2.89 times greater within 30 days than those who did not receive the drug.

Based on this information alone, any well-trained clinical researcher will be able to see through the study’s design flaws.

The New England Journal of Medicine and The Lancet retracted these two studies based on flawed data. But damage was already done to the use of the promising hydroxychloroquine against Covid-19.

Banning hydroxychloroquine paved the way for the mRNA vaccines’ emergency use authorisation (EUA).

The FDA rules allow for EUA of untested or experimental vaccines only if there are no alternative therapeutics.

Prodromos and Rumschlag (2020), in their systematic review of 43 reports using hydroxychloroquine for Covid-19, 25 had positive clinical efficacy, 15 showed no improvement, and three showed worse clinical results. Scientific reports like this are reliable and should inform decision making.

Ivermectin, the anti-parasitic drug repurposed for humans is another interesting case. To date, there are numerous studies using ivermectin on Covid-19 patients. These are mostly small-scale studies self-funded by individual doctors with altruistic intent.   

The study of Lawrie (2020), a systematic review and meta-analysis of 27 studies evaluating ivermectin for prophylaxis and treatment against Covid-19 showed the drug could reduce morbidity and mortality from the infection. This was followed by another poorly designed study aimed to cast negative light on ivermectin.

Lopez-Medina et al (2021), Effect of ivermectin on time to resolution of symptoms among adults with mild Covid-19: The results showed no statistical significance between the ivermectin and the placebo group. The sample size was intentionally small (n=200) to make it difficult to achieve statistical significance.

If the sample size had ranged into thousands, like in vaccine trials, the small positive difference for the treatment and control arms would have shown statistical significance.

In this study, the lead authors declared they received grants from pharmaceutical conglomerates that were also producing Covid-19 vaccines.

What followed after this negative study was obvious – media disparaging ivermectin, a promising drug that is cheap, no longer patentable, shown efficacy in reducing the severity of Covid-19 symptoms and preventing deaths, and has no side effects.   

The case of hydroxychloroquine and ivermectin provides good instruction for policy makers to tread carefully when looking at scientific information. They need to venture into paths less travelled. – May 6, 2021.

* Captain Dr Wong Ang Peng is a researcher with an interest in economics, politics, and health issues. He has a burning desire to do anything within his means to promote national harmony. Captain Wong is also a member of the National Patriots Association.

* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.