THE IVERMECTIN OXFORD TRIAL NEEDS REDESIGNING TO GET CREDIBLE RESULT

I have been working in hospital and the cath lab right through the Pandemic. After considerable deliberation I took 2 shots of the ChAdOx1 vaccine. I have a number (provided by the Indian government) to prove this, and therefore I am not an anti-vaxxer. I am not in the habit nor in the business of misinformation. I am an interventional cardiologist in the vulnerable age bracket and considered vaccination well worth the risk.

But with children the risk benefit ratio does not work very well, and I would wait for more evidence before embarking on mass vaccination in the little guys.

They have had a torrid time the last one and a half years. No school, no education, no sport, no friends, in fact no nothing. Worse they do not have a spokesperson defending them or their cause.

As of now, mercifully, the WHO does not recommend mass vaccination of children.

Oxford investigators in the PRINCIPLE platform are about to begin a randomised trial with ivermectin. Their protocol for the trial, however, leaves must to be desired. It seems so skewed against ivermectin that it is bound to fail.

In India, and Delhi in particular, Iveremectin is used at a dose of 400 to 500 micrograms per Kg for at least 5 days if not longer. Crucially it is supposed to be administered at the earliest, within 3-5 days from symptoms onset for best results.

The PRINCIPLE investigators on the other hand will wait for 14 days from onset of symptoms and use a small dose of 300 micrograms per Kg for only 3 days. This obviously will be suboptimal. Importantly patients who are quite sick will be recruited, those above 65 years, or if younger with some chronic condition such as heart, lung, liver, or neurological disease.

It is imperative that the Oxford investigators redesign their methods for the Ivermectin trial to obtain truer results. The dice ,in their trial, appears to be loaded against ivermectin.