The Mayor of Itajaí, a major port city in the state of Santa Catarina in southern Brazil—a physician and left-leaning politician—has been distributing ivermectin kits totaling 1.5 million tablets, which have been used by about 126,000 of the estimated 200,000 people in the community. Apparently, the city itself set up a distribution center to augment the process. Although the topic of raging debate within this part of Brazil, Mayor Volnei Morastoni declared that he couldn’t “watch the band go by,” meaning do nothing while people died. Hence he made the executive call to fund 4.4 million real ($830K US$) for the ivermectin distribution, declaring the anti-parasitic drug as an acceptable regimen in the town. Some data points lead to a hunch that the approach could be working, but it cannot be proven. In the meantime, the Mayor has pending trouble as State auditors use procurement law to potentially shut down the local public health agency initiative.
COVID-19 in Brazil, including Santa Catarina and Itajaí
Next to the United States and India, Brazil, with 209.5 million inhabitants, has emerged as the pandemic epicenter with 125,659 deaths and a total reported 4,093,586 cases. Itajaí is located in Santa Catarina, in the South Region of Brazil, the seventh smallest state in area and the 11th most populous state. With 6.72 million inhabitants (3% of the country’s total), the state has experienced 1,175 (less than 1% of the total) deaths with a total of 87,982 cases or 2% of the total cases in Brazil.
According to the state government, the city of Itajaí has just over 200,000 residents, and 3,811 COVID-19 cases, including 101 deaths, are reported in the municipality. NCS Total reports that ICU bed occupancy in the city has reached 93.4 percent.
Recent data from Brazil reveals that generally, the State of Santa Catarina is one of the only ones in the South where COVID-19 infections are waning. The three states of Parana, Santa Carina, and the Rio Grande do Sul have been proactive in establishing policies to reduce the threat of COVID-19: from lockdowns and pervasive testing measures to compulsory use of masks and prepared special Intensive Care Units for the initial wave of infected patients which slowed by June. The virus spread again with the loosening of restrictions.
City Health Department
According to the city’s website, its health department informs that the prophylactic treatment of ivermectin is still available for the city’s residents. Moreover, they offer multiple doses and support with administration.
In the meantime, the Brazilian State Court of Auditors (TCE-SC) recommended the city of Itajaí immediately stop the distribution of the drug as a preventive medication for COVID-19. Brazilian media NSC Total reports that state and federal pressure mounts on local jurisdictions approving ivermectin: they posit that because of the lack of scientific evidence of efficacy targeting COVID-19, suspicions of corruption are raised as for the amounts paid for the drug, the bidding process (or lack thereof, etc.)
The state auditing agency continues to prod the city government of Itajaí for full details as to how the department is distributing ivermectin to the population. Apparently, the city’s public health department has established 19 distribution points while the state seeks proof of a scientific basis justifying the purchases. The goal undoubtedly is to find violations of law and possibly force a shutdown.
TrialSite Visitors in Brazil
TrialSite readers send information to the media platform regularly. According to residents and those following this news, a disproportionate number of people aged 60 and above are taking ivermectin, while among younger populations, there is frustration with the lack of more regimented protocols and a lack of clinical trials. According to one TrialSite member, “As an engineer, I go with the numbers and what appears to work.”
Other Cities Distributing Ivermectin
According to NSC Total, four other cities in the State of Santa Catarina have offered autonomy to doctors to prescribe ivermectin to patients including Florianópolis, São José, Chapecó, and Xanxere.
There is no doubt that randomized controlled trials are needed to help generate the evidence as to whether ivermectin truly works or not. TrialSite has accumulated considerable data from interviews, case series, press reports, interviews of physicians in several countries, and analysis of completed ivermectin clinical trials. But more is needed, especially more impact results from at least a few of the 30+ ongoing clinical trials involving ivermectin.