Ever since the advent of the eagerly awaited vaccine, Covishield by Oxford Astrazeneca from Serum Institute of India, on January 27 this year, Bangladesh became one of the notable countries to roll out its vaccination programme against the novel coronavirus. In a month's time, over 1.5 million people have received the first dose of the vaccine and many more are anticipating their turn. The impressive start to the vaccination drive is, indeed, a commendable feat of the government. Beginning with the quick online registration to the smooth and efficacious vaccine administration at the centre, the entire process has been executed in an orderly manner that can be an effective example to be followed by many nations.
However, as the vaccination is currently being administered among a restricted group of candidates in accordance with priority, the general population under the age of 40 is still uncertain as to when they will be vaccinated. While waiting for their turn, it can be safely proposed that people may continue or resort to the use of the FDA approved drug, namely Ivermectin, for prophylaxis until they get vaccinated.
Long since Dr Tarek Alam, Head of Medicine Department of Bangladesh Medical College had announced that Ivermectin, an anti-parasitic drug can be repurposed for treatment and prevention of Covid-19 based on positive research findings by experts in Monash University, Australia, the drug has been widely prescribed by doctors across the nation. Research conducted by Dr Tarek Alam and Dr Rubaiul Murshed, chairperson of Shomman foundation, has been acknowledged not only in Bangladesh but all over the world. icddr'b also conducted one such randomised controlled trial showing great effectiveness of the drug in reducing viral load.
Researchers around the globe came to know for the first time about Ivermectin's effectiveness on Covid-19 patients from Dr Tarek and Dr Murshed's scientific article published in the reputed medical journal, BCPS. Eventually, "Ivermectin" gained rewarding attention in the west also. A meta-analysis conducted by Dr Pierre Kory, President of Frontline Covid-19 Critical Care (FLCCC) Alliance, was published where he emphasised on the preventive effect of Ivermectin by compiling data from researches conducted across the world in Argentina, France, India, Egypt, along with special mention of the research conducted by Dr Alam and his team as a commendable feat on behalf of Bangladesh.
Dr Andrew Hill, Liverpool University virologist, researcher, and consultant to the World Health Organization (WHO), presented data in favour of Ivermectin before the NIH Treatment Guidelines Panel. Dr Hill's "transformational" findings on Ivermectin and Dr Kory's meta-analysis led to the event of NIH upgrading their recommendation on Ivermectin, making it an option for use against Covid-19 in the US. This new designation upgraded the status of Ivermectin from "against" to "neither for nor against", similar to monoclonal antibodies and convalescent plasma, both widely used across the USA. FLCCC said in a press release that doctors should feel more open in prescribing Ivermectin as another therapeutic option for the treatment of Covid-19.
A study conducted between September 20 and October 19, 2020, by All India Institutes of Medical Sciences (AIIMS)-Bhubaneswar in the Indian state of Odisha found that two doses of the potential drug Ivermectin prophylaxis resulted in a 73 percent reduction in Covid-19 infection. Furthermore, another research conducted by the US based researchers Hellwig and Maia published in NCBI earlier this January also showed the correlation of lower incidence of Covid-19 among countries, most commonly in Africa, with routine mass administration of Ivermectin.
In Bangladesh, most cases of Covid-19 are being detected early with the majority of patients recovering without hospitalisation or critical care. According to a leaked inter-agency UN memo dated March 26, 2020 it was predicted that based on the extraordinary human densities in Bangladesh (ranking number 8th in the list of countries by population and comprising 2.11 percent of the entire world population), the impact of Covid-19 without interventions can result in up to 2 million deaths during the epidemic wave. Despite the odds, as of today, only about 8,000 deaths have been reported in Bangladesh. With Ivermectin being taken in nearly every household across the country, the drug is supposedly one of the contributors to the low death rate, early recovery and declining numbers of affected cases reported in Bangladesh.
Needless to say, the use of masks and precautionary measures are of utmost importance regardless of one's vaccination status. However, along with a well-organised nationwide vaccination programme, Bangladesh can strengthen its guard against Covid-19 by continuing the use of the widely available, safe and cheap drug, Ivermectin 12mg to 18mg tablet once every 2 weeks. With the exclusion of pregnant and lactating mothers, this is applicable for those who have not received the vaccine yet and are awaiting their turn; a temporary yet effective shield.
Dr Jonaid Shafiq, Professor of Pain Medicine & MD, Japan-Bangladesh Friendship Hospital. Dr Muzharul Mannan, Consultant, Neurologist & Training Coordinator, IPNA, BSMMU. Dr Pauline Francisca Gomes, Research Fellow, Shomman Foundation.