Future Tense

How Ivermectin Took Over the COVID Skeptic Internet

A woman holds a large box of box of ivermectin while someone behind her unfurls a Brazilian flag.
A supporter of Brazilian President Jair Bolsonaro at a protest organized to show support to his government on May 15. Andressa Anholete/Getty Images

Ivermectin: the latest unproven COVID treatment to blow up the internet. It’s an anti-parasitic used to treat things like river blindness and lice in humans and, quite commonly, worms and other parasites in horses, cows, and dogs. While there are some clinical trials examining ivermectin as a potential treatment for COVID-19, none have suggested that it reduces the disease. One analysis that touted it as an effective treatment had to be withdrawn for ethical reasons.

But now it’s being lauded all over the internet—on Facebook, Reddit, Clubhouse—as an effective COVID cure. People who can’t get a human ivermectin prescription are trying to get their hands on the veterinary version, something the FDA is warning against, because animal formulations are different from those approved for humans and can be dangerous.

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On Friday’s episode of What Next: TBD, I spoke with Brandy Zadrozny, who covers the internet and platforms for NBC News, about how specific corners of the internet helped ivermectin take hold as a COVID cure—and why it’s not the first and certainly won’t be the last bit of health misinformation to gain steam thanks to a handful of tightly linked online communities.

Lizzie O’Leary: I want to take this story bit by bit. How big an issue are we talking about here? Is people taking Ivermectin a crazy fringe thing, or is it really exploding?

Brandy Zadrozny: We know that a lot of people are taking Ivermectin. The CDC has statistics that say prescriptions for ivermectin have risen something like 88,000 per week in August. And prepandemic, we were seeing like 3,600 per week. So a ton of people are taking ivermectin.

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And that in itself, isn’t that big of a problem. Ivermectin is generally safe in low dosages. The problem is that when you take a whole lot of ivermectin, that’s when things get dangerous. We know that poison control centers are being inundated with cases of possible ivermectin toxicity.

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So it is a real problem, enough so that the FDA, the CDC, poison control centers are saying, “Please stop doing this.”

How did Ivermectin catch people’s attention online as a COVID cure?

I first heard about Ivermectin a couple of months ago. These folks that hang out on Clubhouse were touting ivermectin as the new wonder drug for COVID. At the same time, there was this meta-analysis that came out, and there were some other studies that were later retracted as fraudulent which claimed that Ivermectin had therapeutic properties or protective properties against COVID-19. But the damage was done a couple of months ago. Then you saw it slip from those circles to the larger right-wing sphere: Laura Ingram, Tucker Carlson, folks like Phil Valentine, the Nashville radio DJ who—just a few days before he died—touted ivermectin as something that had helped save him. That was the misinformation pipeline that it flowed through, and all the while, these groups were bubbling up on Facebook, Reddit, Telegram.

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In this case, one of the main promoters of ivermectin is a group called America’s Frontline Doctors. Who are they?

America’s Frontline Doctors are a group of technically doctors, though most of them are not clinical professionals, which means they don’t treat COVID patients, which means they are not actually on the front lines. And over the last year and a half, they have been steadily pumping out incorrect, unsupported, unscientific information about COVID-19. They are, as a rule, anti-mask, anti-vaccine, pro-unproven therapeutics like ivermectin.

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Where do they fit into this medical disinformation universe? How big a player are they?

It’s a big universe. Would I call them the number one threat? No. But they are a huge player in COVID misinformation specifically, because they were the first group that really came on the scene wearing white lab coats saying, “You can’t trust the government, but you can trust us. We are doctors.” And it’s something called reputation laundering, where they are benefiting from the idea that they’re in white lab coats, they are doctors, we should be able to trust them, but they’re pedaling this misinformation in a bid to sell lots of things.

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One of the members of America’s Frontline Doctors, Dr. Stella Emmanuelle, she is selling her small business, which is a small clinic in a strip mall in Texas. For Dr. Simone Gold, she is selling her brand, which is a private, bespoke, fancy practitioner in California. So they each have something to sell and they come together, put on white coats, and stand under the banner of America’s Frontline Doctors, and that’s where their power comes from.

It seems sort of crazy that this is even legal.

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We call it the misinformation beat, but it’s really the grift beat. For a decade, I’ve been looking at the anti-vaccination movement, the health supplement movement, the wellness community movement. And the people that are now spreading COVID misinformation have, for a decade, been spreading false cancer cures, then selling false cures for everything from psoriasis to HIV. This is a really common grift.

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How much money are we talking about?

Health misinformation is a super profitable business. We look at people who are at the top of the game, like Joseph Mercola, like Mike Adams, so-called “Health Ranger.” These people live in palaces and make millions of dollars. So there’s no wonder why people would want to get in that game. You add to the fact that because politics and health misinformation are so deeply entwined because of the pandemic, now people can also become media stars. So there is a name and there’s money to be made for yourself.

Some of that money is made online, on websites like speakwithanmd.com that make it easy to get prescriptions. Right now, if you go to the speaktoanmd site, there’s a pop-up message saying they are experiencing overwhelming demand.

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When you go to speakwithanmd.com, you’re greeted with a survey saying, “What do you want? Do you want Ivermectin? Do you not know what you want?” And then they set you up with a network of doctors in your state who will prescribe you the thing that you want off label. So they’ll prescribe you that off-label Ivermectin. Then they send that prescription to an online pharmacy and that online pharmacy is supposed to get the medicine to you. It’s worth noting that there are thousands of complaints that this whole thing is a scam from people who never get linked up with a doctor, who never get linked up with the prescription. So it’s not a perfect system.

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Are there links between speakwithanmd and America’s Frontline Doctors?

American Frontline Doctors seems to be working in a sort of affiliate role for this website, speakwithanmd, which was just started in March of 2020. There is no about section, there’s no way to contact their owner. But speakwithanmd.com/americasfrontlinedoctors will take you to the ivermectin and hydrochloroquine request page. So it seems to suggest that America’s Frontline Doctors is actually getting a cut or a percentage of every person that gets referred to the site that way.

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When you look at groups like this, are they targeting places or people who are already primed to be skeptical of the mainstream medical system? Or are they converting folks who are unsure and frightened?

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Why not both? You have your hardcore stable of people who have been long in the anti-vaccination movement or big consumers of far-right media who are primed already to accept this message, but the Delta variant is happening now and so there are lots of people who were hesitant to get the vaccine, truly hesitant, and wanted to wait and see if it had some sort of long-lasting effects, just waiting for some reason. Those people are seeing their communities and often their whole families being affected by the Delta variant, and we’re seeing those people log onto the group saying, “I need ivermectin now,” because they’re not vaccinated and they need help because a loved one or they, themselves are sick.

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People who are willing to dose themselves with horse paste are afraid of something, right? And they’re not just afraid of COVID. Where does that skepticism of the vaccine or the FDA come from? Would it be a mistake for someone listening to this to say, “Those are just a bunch of crazy people?”

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Well, a lot of it is political. We know that from polling about people who are definite, “I’m never getting the vaccine,” people. It’s a political ideology. I don’t think they’re crazy. That’s just what they believe. And they have, again, just a hodgepodge of outlets willing to tell them that they’re doing the right thing. And then they do go on social media and they find their tribe with the click of a button. It’s a non-ending feedback loop of, “You’re doing everything right.” And that’s the sort of danger with social media here.

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All of the major platforms here, Facebook, Reddit, etc., have said that they are taking steps to push back against this. What have you found?

I have this sort of doomsday outlook when it comes to the platforms at this point, because with health misinformation, it just feels like it’s too late almost. All of the platforms have thrown up their hands at this point and said they’ll remove stuff, but it’s just not effective. Facebook has this policy against promoting misinformation of COVID cures specifically, and that includes ivermectin, but we found dozens of groups really easily. We joined them.

There’s this thing that online groups have done forever called l33ting, which is where people will change the spelling of things to avoid moderation. It’s sort of a cat and mouse game. And I can tell you absolutely that moderation teams are not well versed enough in this to understand when people are abusing the platform.

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I think anyone listening to this will say, “Wait a minute, we have been here before with hydroxychloroquine.” Why do you think these things keep happening? Would they happen anyway without this online ecosystem and we wouldn’t know about them? Or is it truly amplifying these questionable “cures”?

I think to just say that this is an online problem is ludicrous, right? Even the Phil Valentine stuff, shows us the power of radio in conservative circles. So it is a problem of all of these things. It is a problem of traditional media, like Fox News, it is a problem with far-right media, online media, digital media like Breitbart, it is a problem with Facebook. It’s just all of these things together.

Misinformation and disinformation is just lies. It just means lies. And so who is lying to you? Who is harmed by those lies? And who is profiting? That is always the way that I like to look at any of these stories.

Future Tense is a partnership of Slate, New America, and Arizona State University that examines emerging technologies, public policy, and society.

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