The world is changing fast and to keep up you need local knowledge with global context.
The article was first published on 10 August 2021
Ivermectin and its use for the prevention and treatment of Covid-19 has become a majorly controversial issue, with many being angered by BizNews for providing a platform to those experts who passionately advocate in favour of Ivermectin. In July, BizNews founder Alec Hogg spoke to Professor Colleen Aldous – an Associate Professor and Clinical Researcher at the University of KwaZulu-Natal who has boldly spoken out in favour of Ivermectin. Aldous stated clearly that she does not believe that Ivermectin is a ‘miracle drug’, but that there is more than enough evidence pointing towards its effectiveness. In July, BizNews published an article written by Professor Aldous in which she argued that the placement of our trust in a small group of experts who advocate against ivermectin is being done at the potential cost of human life. With the fact-based evidence in respect of Ivermectin’s efficacy in the treatment of Covid-19 reaching an insurmountable level – one has to ask what the reasons are for the vehement argument against its use by institutions like the World Health Organisation. In this article, Dr EV Rapiti – a General Practitioner in Cape Town – responds to comments and recommendations by Dr Emmanuel Taban (a pulmonologist practicing in Mediclinic Hospital) that Ivermectin is the direct cause of three out of five deaths of his patients with acute respiratory disorder through liver failure. Dr Rapiti’s response is based on his own experience using Ivermectin to treat his patients. In the video embedded at the bottom of this article, Dr Paul Marik – a founding member of the FLCCC Alliance – also responds to Dr Taban’s severe claims about Ivermectin at 32m40s into the webinar. BizNews once again attempted to arrange a debate between experts around the use of Ivermectin in the treatment of Covid-19, however – none of the professionals who have been outspoken against Ivermectin were willing to participate. In lieu thereof, we spoke to Professor Aldous, Dr Nathi Mdladla and Dr Pinky Ngcakani – all of whom are strongly in favour of Ivermectin. The discussion was both insightful and moving. – Nadya Swart
Science relies on facts, Dr Taban, not histrionic speculation
By Dr E.V RAPITI*
An excerpt from Transformative Health Justice (24 July 2021)
The comments and recommendations by Dr Emmanuel Taban (a pulmonologist practicing in Mediclinic Hospital) – that Ivermectin is the direct cause of three out of five deaths of his patients with acute respiratory disorder through liver failure, (without any constructive and scientific basis) – is an attempt to discredit a drug that is safer than aspirin or paracetamol.
My experience using Ivermectin to save lives
I have treated over 450 patients with this drug in the last two months and I have not had a single death. I have treated over 140 patients with pneumonia and all of them survived. I have sent only two patients to hospital because we could not access portable oxygen. With portable oxygen and my protocol, I have treated patients with oxygen levels of sixty and seventy percent at home. One of the patients I treated was discharged after being in the hospital ICU for two months with an oxygen level of 60% with an oxygen tank and no medications or follow up. In one month of treatment, I managed to wean him off his oxygen and bring his oxygen levels up to 95% . He is now ambulatory after being bedridden. The majority of my patients that presented early with symptoms or with early pneumonia made a dramatic recovery within three days. I have not encountered a single patient presenting with an adverse event from the drug. For the delta variant, I used very high doses early because the delta variant is a far more virulent strain than previous strains. So, I was flabbergasted when I read Dr Taban’s untested claim that his patients were dying from liver failure, without producing the evidence.
The liver problem that is NOT due to Ivermectin
I decided to research the relationship between Acute Respiratory Distress Syndrome and acute liver failure. The following is an excerpt from the INSPIRES IV study, which I would urge all doctors – and especially, Dr Taban – to study. “Proceedings from the Fourth International Symposium on Acute Pulmonary Injury and Translation Research (INSPIRES IV): Patients with liver diseases are at high risk for the development of acute respiratory distress syndrome (ARDS). The liver is an important organ that regulates a complex network of mediators and modulates organ interactions during inflammatory disorders. Liver function is increasingly recognised as a critical determinant of the pathogenesis and resolution of ARDS, significantly influencing the prognosis of these patients. The liver plays a central role in the synthesis of proteins, metabolism of toxins and drugs, and in the modulation of immunity and host defense. However, the tools for assessing liver function are limited in the clinical setting, and patients with liver diseases are frequently excluded from clinical studies of ARDS. Therefore, the mechanisms by which the liver participates in the pathogenesis of acute lung injury are not totally understood. Several functions of the liver, including endotoxin and bacterial clearance, release and clearance of pro-inflammatory cytokines and eicosanoids, and synthesis of acute-phase proteins can modulate lung injury in the setting of sepsis and other severe inflammatory diseases”.
Because Dr Taban’s claims are based on wild conjecture, without any scientific evidence, that three of his patients died of liver failure through Ivermectin, I felt it was imperative to investigate the likely pathophysiology that led to his patients’ deaths and reassure the confused public that his statement that Ivermectin caused the deaths of his patients is utterly baseless and void of justification.
- Firstly, when one makes such a bold statement condemning a drug that has an excellent safety profile, one has to produce good evidence for it.
- Secondly, raised liver enzymes does not constitute liver failure but the result of insults to the liver through drugs and infections. The relationship between Acute Respiratory distress syndrome and acute liver failure is bidirectional. What that means is that if liver is severely damaged it will lead to severe toxicity and sepsis because it can no longer produce APPS,(acute phase proteins) to rid the body of toxins and prevent clotting. This could eventually lead to respiratory failure.
- On the other hand in the case of Acute Respiratory Distress Syndrome, as in SARs COV2, the alveolar cells are filled with liquid mucous and the pulmonary vessels around the cells and the vessels all over the body can be blocked through clotting. No organ, including the liver is spared. It can and often affects every organ of the body.
- When the liver is damaged through severe clotting and anoxia, it will fail and lead to liver failure. Yes, the enzymes would be raised but that would not mean that the patient has liver failure. In all likelihood, the patients die of acute respiratory failure before they can manifest signs of liver failure, so fail to fathom how Dr Taban arrived at such a bizarre conclusion.
- Treatment of acute respiratory syndrome requires as many as ten different drugs, many of which can be hepatotoxic, so damage to the liver cannot be apportioned to one single drug. Prednisone, which is used in huge amounts to treat the inflammation, stimulate the P450 cytochrome enzyme system. This in turn enhances the metabolism of Ivermectin, reducing its levels automatically. So theoretically, the Ivermectin dose is considerably reduced and if they are under Dr Taban’s care, who does not use Ivermectin, the drug levels are even further reduced.
I hope that the above explanation makes it quite obvious that it is impossible to implicate one drug to be the cause of liver failure when it is one of many hepatotoxic drugs that are used to treat Covid pneumonia, except in Dr Taban’s unit. I feel that Dr Taban’s claim is totally unjustified and he should do the right thing and withdraw his half-baked and unscientific conclusion, and apologise to the general public for wilfully misleading them.
Dr Paul Marik, a world-renowned critical care specialist, described Dr Taban’s comments as utterly fake. Dr Paul Marik’s specifically addresses the misinformation from ‘certain’ South African doctors in the FLCCC’s weekly webinar last week. Here is why you should take this South African seriously:
- Dr. Marik is currently a tenured Professor of Medicine and Chief of the Division of Pulmonary and Critical Care Medicine at Eastern Virginia Medical School in Norfolk, Virginia.
- Dr Marik has been cited over 43 000 times in peer-reviewed publications and has an H-index of 77. He is the second most published critical care physician in the world, and is a world renowned expert in the management of sepsis — his contributions to the understanding and management of the hemodynamic, fluid, nutritional, and supportive care practices in sepsis have transformed the care of patients throughout the world.
- Academic qualifications MBBCh, Bachelor of Medicine and Surgery, University of Witwaterstrand D.Hom.Med, Diploma in Alternative Medicine, Bantridge Forest school, Sussex, UK D.Av.Med, Diploma in Aviation Medicine, South African Defense Force M.Med, Master of Medicine, University of Witwaterstrand BSc (Hons) Pharmacology, University of Witwaterstrand DTM&H, Diploma in Tropical Medicine and Hygiene, University of Witwaterstrand FCP (SA), College of Medicine of South Africa DA (DA), Diploma of Anesthesia, College of Medicine of South Africa FRCPC, Royal College of Physicians and Surgeons of Canada PNS, American Board of Physician Nutrition Specialists UCNS–NCC, United Council for Neurological Subspecialities Certification South African Medical and Dental Council, General Practitioner, Specialty certification in Internal Medicine, Sub-specialty certification in Critical Care Medicine British Medical Council, General Practitioner, Specialty certification in Internal Medicine Canadian Medical Council, General Practitioner, Specialty certification in Internal Medicine, Sub-specialty certification in Critical Care Medicine American Board of Internal Medicine (ABIM), Internal Medicine, Critical Care Medicine American Board of Physician Nutrition Specialists, Physician Nutrition Specialist United Council for Neurological Subspecialities (USA), Neurocritical Care Specialist Publications (Google Scholar and Harzings PoP) Publications 744 (as listed by Google Scholar) Citations 41 274 Citations/paper 44 Authors/paper 2.43 H index 97 Expertscape’s PubMed-based algorithm: “World Expert” on the topic of sepsis being top 0.1% of scholars writing about Sepsis over the past 10 years. https://www.expertscape.com/ex/sepsis Citation Metrics according to the top 100 000 scientists in all disciplines as published by Ioannidis JP et al. A standardized citation metrics author database annotated for scientific field. PLoS Biol 2019; 17(8): e3000384 World Ranking: 734 (top 0.01%) Number of publications: 524 Number Citations: 18 899 H Index: 66 FLCCC Alliance CV | Paul Marik 3 / 80 www.flccc.net Critical Care and Emergency Medicine World Ranking: 2 Academic Degrees and Fellowships 1981 University of the Witwatersrand, Johannesburg, South Africa.
- Founding member of the FLCCC Alliance and co-author of the MATH+ and I-MASK+ Prophylaxis and Treatment Protocols for COVID-19
- Contributions to the Field of Medicine Dr. Marik has special knowledge and training in a diverse set of medical fields, with specific training in Internal Medicine, Critical Care, Neurocritical Care, Pharmacology, Anesthesia, Nutrition, and Tropical Medicine and Hygiene. Dr. Marik is currently a tenured Professor of Medicine and Chief of the Division of Pulmonary and Critical Care Medicine at Eastern Virginia Medical School in Norfolk, Virginia.
- Dr. Marik has written over 500 peer-reviewed journal articles, 80 book chapters and authored four critical care books. He has been cited over 43,000 times in peer-reviewed publications. He has delivered over 350 lectures at international conferences and visiting professorships. He has received numerous teaching awards, including the National Teacher of the Year award by the American College of Physicians in 2017. He led the Society of Critical Care Medicine task force on corticosteroids in sepsis. He has already co-authored 10 papers on many therapeutic aspects of COVID-19.
- Full CV here: https://covid19criticalcare.com/wp-content/uploads/2021/01/FLCCC-Alliance-member-CV-Marik.pdf
Let’s talk facts, shall we?
- There have been over 50 randomised controlled trials proving the efficacy of the drug to save lives from Covid. The meta-analysis of 21 randomised controlled trials by independent and world renowned researcher, Dr Tess Lawrie, revealed that the drug has reduced deaths by 80%.
- One of the peer reviewed articles written by Dr P Kory and Dr Paul Marik, proving the efficacy of the drug was published in the journal of pharmaco-therapeutics. It will serve him well to read the article.
- Dr Andrew Hill of the WHO was busy conducting studies on the safety of the drug and during his research he strongly recommended that the entire world should stock up on the drug to fight the disease. He was, it appears, silenced for speaking up for the drug and he refused to comment on his recommendation when he was subsequently asked about it.
- In places like Mexico, Peru, and in the states of Uttar Pradesh and in Goa in India the incidence of deaths and hospitalisation plummeted drastically to near zero ever since the drug was used on a wide scale. The head of the WHO advised India not to use the drug to treat Covid, basing it on the compromised advice of Merck, clearly making her the mouth piece of a drug company, instead of being the spokesperson of the desperate citizens of the world. For her misdemeanor and unscientific advice, the Indian Bar Association has lodged a case against her for misinformation.
- Studies on the prophylactic use of the drug on health workers in Bangladesh and South America showed that the drug had a significantly lower incidence of Covid-19 in the group that used it compared to the group that didn’t use it.
- The CDC recommended the use of the drug on the elderly for scabies at a dose of 0.2mg / kg for seven days. Why would they recommend it, if it wasn’t safe especially for the elderly, who often have compromised organ function through age and chronic illness?
- Efficacy of drugs is determined through the following methods: meta-analysis, randomised controlled trials, observational, experience and expert opinion. I have thus far mentioned the results of RCTs and observational studies, which revealed that the drug is extremely effective in combating the disease.
- Prof Eli Swartz, an established infectious disease specialist, who has extensive knowledge on the drug, when the drug was widely used to treat parasites, did a recent study, where Covid positive patients were treated with the drug on about 400 patients. His study showed that the group that used the drug, had no virus in them after forty eight hours.
- When it comes to experience, a specialist physician in the Philippines testified in court that he successfully treated over 800 patients in his hospital and he did not have a single death.
- Dr Rapiti is a General Practitioner and published author in South Africa.
Cyril Ramaphosa: The Audio Biography
Listen to the story of Cyril Ramaphosa's rise to presidential power, narrated by our very own Alec Hogg.