No proof that drugs not approved in US for COVID-19 caused drop in cases in India

On May 17, the New York Times reported that the coronavirus crisis was so severe in India, with about 23 million infections confirmed, that the country was accounting for more than half of the world’s daily COVID-19 cases. 

The same day, The Gateway Pundit posted a story suggesting that two drugs — both of which have drawn warnings from U.S. and global public health officials not to be used for COVID-19 — were having dramatic effects in India. 

The headline, widely shared on Facebook, read: "Elites Worried: COVID Cases in India Plummet After Government Promotes Ivermectin and Hydroxychloroquine Use."

The post was flagged as part of Facebook’s efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook.)

Daily COVID-19 cases in India decreased in the days before May 17 —  but only after a nearly vertical rise that started in April and peaked May 8. The Indian government has recommended limited use of the two drugs for COVID-19, but there is no evidence that their use led to the drop in cases. 

Neither drug is approved in the U.S. for COVID-19. And both the U.S. Food and Drug Administration and the World Health Organization recommend against using them to prevent or to treat COVID-19 infection. 

The Gateway Pundit article was written by the site’s founder and editor-in-chief, Jim Hoft, whose Twitter account was permanently suspended in February for "repeated violations" of Twitter’s policies on election-related messages, according to news reports.

The Gateway Pundit article links to another article that links to revised guidelines issued April 28 by India’s Ministry of Health & Family Welfare. The guidelines, for "home isolation of mild/asymptomatic COVID-19 cases," recommends considering ivermectin as treatment for those patients, and says people in close contact with those patients should take hydroxychloroquine as a prevention "as per protocol and as prescribed by the treating medical officer." 

Hoft did not respond to a request for evidence to support his claim.

Confirmed new COVID-19 cases in India declined in the days before the article was posted, based on a seven-day rolling average — but only after reaching a peak following a sharp increase that started in April. 

The seven-day average of new daily cases was 319,497 on May 17, the date of the post, down from a peak of 391,232 on May 8, according to Our World in Data. The U.S. average was 32,036 on May 17.

Many experts caution that the Indian government’s official tallies of confirmed cases likely vastly underestimate the actual infection figures because testing remains limited and the volume of cases has crippled the health care system in some areas. So the actual extent of the decline is not clear.

Hydroxychloroquine and ivermectin are being widely used in India for COVID-19, according to news reports. But there is no evidence they led to the recent decline in confirmed cases, given the lack of clear scientific evidence that they are effective at all in prevention or treatment.

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The government’s new guidelines don’t give a rationale for the recommendations. They were issued several days after a research paper was published that said "results from numerous controlled prophylaxis trials," including some done in India, "report significantly reduced risks of contracting COVID-19 with the regular use of ivermectin." 

Doctors in India admitted to have prescribed the drug under compulsion, peer pressure or on patient’s demand, according to one news report . The health minister in Goa was quoted as saying ivermectin does not prevent a COVID-19 infection, but helps in reducing the severity of the disease. 

Hydroxychloroquine has been in use much longer. In June 2020, a task force of India’s health ministry recommended that frontline health care workers take it to prevent COVID-19 infection. According to the journal Nature, the task force cited three new studies conducted by government agencies, only one of which had been published, that the task force said showed it can prevent infection.

Leading U.S. and global health authorities recommend against using the two drugs for COVID-19.

In March 2020, the U.S. Food and Drug Administration authorized emergency use of hydroxychloroquine, which is FDA-approved to treat or prevent malaria, for certain hospitalized COVID-19 patients. But the FDA revoked its authorization less than three months later, after determining "it is no longer reasonable" to believe that it may be effective in treating COVID-19, "nor is it reasonable to believe that the known and potential benefits of these products outweigh their known and potential risks." 

The FDA continues to recommend against using it for COVID-19.

In guidelines issued March 2 on drugs to prevent COVID-19, the World Health Organization said: "We recommend against administering hydroxychloroquine prophylaxis to individuals who do not have COVID-19 — strong recommendation, high certainty evidence." And in guidelines issued March 31 on treating COVID-19, the organization gave a "strong recommendation against hydroxychloroquine in patients with COVID-19 of any severity."

In the treatment guidelines, the World Health Organization said: "We recommend not to use ivermectin in patients with COVID-19 except in the context of a clinical trial," citing "very low certainty evidence" about the drug.

The FDA, in an article March 5, said ivermectin should not be used to prevent or treat COVID-19. Ivermectin, which is FDA-approved to treat conditions caused by parasitic worms and parasites such as lice, in large doses "is dangerous and can cause serious harm." An FDA posting April 26 noted that a June 2020 research article described the effect of ivermectin on the coronavirus in a laboratory setting, but that more testing is needed to determine whether ivermectin might be appropriate to prevent or treat coronavirus or COVID-19.

In April, we rated as False a claim on social media that "mountains of data" show drug ivermectin "basically obliterates" COVID-19 transmission. Some limited studies suggest that ivermectin can help treat COVID-19; others show no significant impact. Many of the studies had small sample sizes and other limitations.

"It would therefore be premature to conclude absolutely that ivermectin has no place in COVID-19 treatment," Gordon Dent, a senior lecturer in pharmacology at Keele University School of Medicine in England, wrote in April. "On the basis of current evidence, however, its use cannot be recommended."

The Gateway Pundit claimed: "COVID cases in India plummet after government promotes ivermectin and hydroxychloroquine use."

COVID-19 cases in India, one of the worst-hit countries in the world by the coronavirus, dropped in mid-May only after a nearly vertical spike in cases over the previous several weeks. The Indian government has given limited recommendations for using the two drugs in connection with mild COVID-19 cases.

There is no evidence that the two drugs caused or contributed to a decline in cases in India. Neither is approved in the U.S. for COVID-19. And both the U.S. Food and Drug Administration and the World Health Organization recommend against using them to prevent or to treat COVID-19 infections, citing lack of scientific evidence of their effectiveness and the potential for serious side effects.

For a misleading statement that has an element of truth, our rating is Mostly False.