The Emerson Animal Hospital had only the last 10 milliliters of ivermectin left.
For months, the West Point, Mississippi Veterinary Center had watched the supplies of the drug dwindle. Dr. Karen Emerson, the vet who owns the hospital, started the year with a 500-milliliter bottle of ivermectin, which she uses to kill parasites in dogs, chickens and other patients. But when the bottle emptied and her staff tried to find more, they could only get a 50 milliliter vial. Everyone else told them: None available.
So Emerson began rationing the medicine to give it to snakes and other exotic animals for which she had no other deworming treatment. She urged dog owners to pay for a more readily available replacement drug that can cost seven times as much.
Emerson was surprised at the scarcity of ivermectin as it was always abundant. But she put two and two together after people flocked to her clinic to ask about the drug’s use to treat COVID-19.
“I really think that’s why we have a shortage because so many people are using it,” she said.
For more than a year, misinformation that ivermectin is effective in treating or preventing the coronavirus has been rife on social media, podcasts, and talk radio. Even though the Food and Drug Administration has said the drug is not approved to cure COVID and has warned people not to take it, media figures who have voiced doubts about coronavirus vaccines, like podcaster Joe Rogan, have given ivermectin for advertised exactly this purpose.
The inaccuracies have resulted in some people overdosing on certain formulations of the drug, which has become overwhelming for doctors and hospitals. But at the bottom of the misinformation trail are people like Emerson, who regularly use the drug for the animal treatments for which it has been approved.
Dr. Karen Emerson advised dog owners to pay for a more expensive drug instead of using ivermectin. (Houston Cofield / The New York Times)
While certain versions of ivermectin can treat head lice and other ailments in humans, other formulations – available in liquid and paste forms – are common in the equine and livestock industry to get rid of worms and parasites. People are increasingly trying to get these animal products to ward off or fight the coronavirus, said farmers, ranchers and suppliers.
The demand has put a strain on the world of horses and livestock. Jeffers, a national pet supplies retailer, recently increased the price of ivermectin paste from $ 2.99 to $ 6.99 per tube. Overwhelmed with orders, a Las Vegas farm shop began selling the drug only to customers who could prove they owned a horse. In California, a rancher was told that the order book was so high that she was ranked 600th for the next batch.
The shortage has caused some farm owners, ranchers and veterinarians to switch to generic or more expensive alternatives for their animals. Others have used expired ivermectin or silently stored the drug when they could. Many were alarmed.
“I’m pretty worried,” said Marc Filion, the owner of Keegan-Filion Farm in Walterboro, South Carolina, which uses the drug on his 400 pigs and 25 cattle. If he cannot treat his pigs with the drug at 5 weeks of age, they could develop diarrhea and possibly have to be killed.
These experiences underscore the real impact of misinformation and how far the consequences can spread, said Kolina Koltai, a University of Washington researcher who studies online conspiracy theories.
“It doesn’t just affect the communities that believe in misinformation,” she said. “This even affects people who are not involved in the vaccine – it affects horses.”
Last month, prescriptions for human formulations of ivermectin rose from pre-pandemic 3,600 to more than 88,000 per week, according to the Centers for Disease Control and Prevention. Data on people who bought animal ivermectin were not available.
In a statement, the FDA said it had not received reports of ivermectin deficiencies, but “recognizes that access to animal ivermectin is important for ranchers, farmers and horse owners to maintain herd and animal health”.
Dr. Karen Emerson, a veterinarian, poses with a patient in West Point, Miss., Sept. 18, 2021. She uses the worming drug ivermectin to treat snakes, chickens, and rabbits. (Houston Cofield / The New York Times)
The agency posted on Twitter last month that people shouldn’t use the drug for COVID and wrote, “Seriously, all of you. Stop it.”
Misinformation about ivermectin as a potential COVID cure began to spread just weeks after the pandemic broke out. In April 2020, scientists from Monash University in Melbourne, Australia released preliminary results showing that the drug could kill the coronavirus within 48 hours when used in a laboratory setting. Monash University warned that the results were early and that research would continue.
“DO NOT self-medicate with ivermectin or use ivermectin that is intended for animals,” it says on its website.
A week later, the FDA issued a warning to use the animal formulations for COVID. All the same. The results quickly spread online, fed by other studies showing positive effects of the drug on coronavirus patients. At least one study was withdrawn.
Inaccurate information has since spread on social media sites like Reddit and Facebook. In a Facebook group, Ivermectin COVID-19 Testimonials, 4,200 members share advice on what side effects to expect when taking the drug and how to calculate the dosage of the paste for horses. The discussions are often repeated in podcasts and elsewhere.
“Do you take ivermectin paste orally or do you rub it into the skin?” Read a recent post in the Facebook group.
“Put it on a cracker with a dollop of peanut butter on the same cracker,” replied one commenter.
Facebook said it removed content related to potential ivermectin transactions as well as any claims that the drug was a guaranteed cure. Reddit said it encourages open discussions as long as the discussions don’t violate its guidelines.
As the drug grew in popularity, some veterinarians prepared for a shortage. Last year, Dr. Juliana Sorem, a veterinarian at WildCare, an urban research center in San Rafael, California that treats injured wildlife, has a two-year supply of the drug. Her director told her to act as soon as they heard people were using it against COVID.
“We tried to be proactive,” said Sorem. WildCare has now stowed six precious bottles.
Others didn’t move that fast – and regretted it. Judi Martin, the manager of Skyline Ranch, an equestrian center in Oakland, Calif., Said her brother warned her earlier this year to stock up on ivermectin after taking it to prevent COVID. Martin said she didn’t take him seriously.
Nine months later, Martin’s supplier was sold out. She said the supplier called the drug “liquid gold” and told her it would be in the 600th position for the next shipment.
Some traders have made adjustments to meet increasing demand. News spread quickly last month that V&V Tack & Feed, a Las Vegas pet supply store, had posted a sign saying that customers must show a picture of themselves with their horse in order to buy ivermectin.
“I’m keeping it for my horse people because they need it,” said Shelly Smith, the saleswoman who put up the sign. “That’s what I’m protecting.”
Ruth Jeffers, owner of Jeffers, the pet supplies retailer, said she sold out ivermectin paste on her website this year. After filling up with more expensive versions, these tubes were also sold out.
This spring, for example, she limited new customers to five tubes. Partly driven by demand, it raised the price of Jeffers-branded ivermectin, its cheapest option, from $ 2.99 to $ 4.99 per tube – and then to $ 6.99 per tube.
“It’s hard to make a circus out of your # 1 product,” said Jeffers.
The last vial of ivermectin at Emerson Animal Hospital in West Point, Miss. on September 18, 2021. (Houston Cofield / The New York Times)
At the Horsey Haven Retirement Home in Newcastle, California, a retirement stable for retired horses, the shortage of affordable ivermectin recently sparked a cost debate. Laura Beeman, the owner of Horsey Haven, said she had long used the drug to kill worms in the stable’s 28 horses. The treatments take place four times a year free of charge for the horse owners.
But with drug prices soaring, Beeman wasn’t sure she could continue to offer the service for free. She said she could start charging owners for the now $ 7.99 tubes of paste that previously cost $ 1.99.
“At this point I don’t have any,” she said.
Emerson said her veterinary clinic typically goes through two 500-milliliter bottles of ivermectin a year. Since opening her 3,500-square-foot hospital seven years ago, she added, she has “never” had trouble getting the drug.
Her first hint that something had changed came two months ago when pet owners started asking about the drug used to treat the coronavirus. Last month her housekeeper said her sister had ivermectin in her coffee.
Emerson tried to top up the drug but only found the 50-milliliter bottle. Now she said she knew why.
Since then, she has done her best to slow down the use of the drug in her community, she said. In an interview with a local TV station in August, she warned people about the dangers of taking ivermectin and the effects a deficiency could have on animals. When people ask about the drug, she also explains the dangers of off-label use.
With only 10 milliliters left, Emerson estimated she would run out in the next month.
“If I still have a flock of leg mites, I can’t help them,” she said. “And then I don’t know what we’re going to do.”