Sharp Reductions in COVID-19 Case Fatalities and Excess Deaths in Peru in Close Time Conjunction, State-By-State, with Ivermectin Treatments

On May 8, 2020, Peru’s Ministry of Health approved ivermectin (IVM) for the treatment of COVID-19. A drug of Nobel Prize-honored distinction, IVM has a proven safety record in 1.3 billion doses distributed worldwide since 1987. It has exhibited major, statistically significant reductions in case mortality and severity in 11 clinical trials for COVID-19, three with randomized controls. The indicated biological mechanism of IVM against COVID-19 is the same as that of antiviral antibodies generated by vaccines—binding to SARS-CoV-2 viral spike protein, blocking viral attachment to host cells. Upon this May 8 authorization, mass public and private distributions of IVM for inpatient and outpatient COVID-19 treatments were conducted in Peru. These treatments were deployed soon after rising case incidence and fatalities in each of Peru’s 25 states but Lima, where treatments were delayed four months until August. Analysis was performed using Peruvian public health data for all-cause deaths and for COVID-19 case fatalities for ages 60 and above. These daily figures were retrieved and analyzed by state. Case incidence data were not analyzed due to variations in testing methods and other confounding factors. For the 24 states with early IVM treatment (and Lima), excess deaths dropped 59% (25%) at +30 days and 75% (25%) at +45 days after day of peak deaths. These respective figures for independently tracked case fatalities likewise dropped sharply in the 24 states but not in Lima, yet six indices of Google-tracked community mobility rose progressively over the same period. For nine states where IVM was distributed over a short period through a national program, Mega-Operación Tayta (MOT), excess deaths at +30 days dropped by a population-weighted mean of 74%, each drop beginning within 11 day after MOT start. Extraneous causes of mortality reductions were ruled out. The sharp major reductions in COVID-19 mortality following IVM treatment in Peru’s population of 4.1 million age ≥ 60 parallel results of clinical trials. Its safety well established even at high doses, IVM is a compelling option for immediate, large scale national deployments as an interim measure and complement to pandemic control through vaccinations.