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The anti-Covid vaccine crisis is all about mistrust. Ivermectin is a case in point.

The horse dewormer's popularity has substantial implications for how we go about trying to persuade those resisting the vaccines.

The antiparasitic drug ivermectin has no proven ability to treat Covid-19, but it’s flying off shelves across America because anti-vaccination circles and some conservative groups are billing it as a miracle cure. Some people are even turning to powerful, foul-tasting veterinary versions of the medicine used to deworm horses and cows to self-medicate — and calling in to poison control centers after having been overwhelmed by the dosage. And its popularity has been spiking even after some conservative media figures who touted its benefits have died from Covid-19.

The surging interest in ivermectin — substantial enough to prompt the Food and Drug Administration to warn in a tweet “You are not a horse” — is the latest symbol of our nation’s inability to reach consensus over how to deal with Covid-19. But as a phenomenon, its rise has some qualities, including endorsements from so-called experts, that underscore a major source of our crisis: a decline in trust in any institutions or authorities outside one’s political or cultural in-group. And that in turn suggests that the issue isn’t teaching people science but rebuilding the social bonds of our society.

Ivermectin is widely used to treat parasites in humans and in animals. As Dr. Ryan Marino, a medical toxicologist, notes for NBC News THINK, it does have antiviral effects at very high doses: doses that are too high for safe use in humans. Researchers have looked into ivermectin and consistently found that it neither prevents nor effectively treats Covid-19. Furthermore, studies that have suggested that it’s effective in treating Covid-19 have turned out to be fake, as Marino explains:

The only papers that showed any significant benefit for ivermectin have been retracted because they were fraudulent, but not before being shared hundreds of thousands of times around the world. The same disgraced Surgisphere server — a data sharing and analytics company that rose to prominence early in the pandemic — that posted fraudulent hydroxychloroquine science shared another fraudulent paper on ivermectin that set off this current craze. That paper and Surgisphere no longer exist, but the damage is done. Another popularly shared study on ivermectin, which claimed to demonstrate better success than almost any other medical intervention in modern history, was also found to be falsified and was retracted. But again, only after being shared extensively online.

Ivermectin’s appeal is often attributed to an “epidemic of science denial,” but it’s important to note that ivermectin is a serious drug whose efficacy against Covid-19 has been studied and that false information resembling serious scientific study was published and circulated across the internet. Which is to say, the discourse surrounding ivermectin is nothing like the theory, floated by the former president, that perhaps people could inject disinfectant to protect themselves from the coronavirus. Instead, statements promoting ivermectin may carry an aura of credibility for those who encountered the fraudulent studies and are thirsting for an alternative to taking a vaccine.

Ironically, that these studies were retracted and a major server hosting one of them was taken down may strengthen its appeal among the anti-vaccination crowd, who are primed to believe that “the medical establishment” wants to conceal alternatives to the vaccines. Coronavirus conspiracy theory researchers have documented that some vaccination skeptics believe the government is trying to hide alternatives treatments for Covid-19 because it profits off the vaccines. Of course, the government isn’t making money from vaccines, and it doesn’t control what’s published in scientific journals. But to people who subscribe to conspiracies about the vaccines, the disappearance of a seemingly serious piece of data validating their worldview — that the vaccines aren’t necessary — confirms their mistrust of mainstream authorities.

Two major groups helping to popularize ivermectin as a Covid-19 treatment claim to be medical experts, another sign that ivermectin’s popularity reflects America’s authority crisis rather than simple anti-science attitudes. America’s Front Line Doctors and the Front Line COVID-19 Critical Care Alliance have leveraged appearances of medical professionalism while promoting the ivermectin cure. To be clear: These fringe groups of contrarian physicians are small and have damning track records. America’s Front Line Doctors is reported to be involved in fraudulent business practices involving charging people and failing to deliver on prescriptions and consultations, and it is violating FDA guidelines prohibiting Covid-19 misinformation. And the journal Frontiers in Pharmacology dropped a study by the Front Line COVID-19 Critical Care Alliance after it was discovered that the authors made unsubstantiated claims and promoted their own treatment protocols, in violation of the journal’s editorial code. But ultimately, these groups have successfully created the optics of people in white lab coats dispensing medical advice.

So why are these groups trusted? They have unique credibility with hard-core right-wingers and anti-vaxxers. The founder of America’s Front Line Doctors entered the U.S. Capitol on Jan. 6, and early during the pandemic, the group pushed false claims that hydroxychloroquine was a miracle cure for Covid-19, an effort that was embraced by Donald Trump. And the Front Line COVID-19 Critical Care Alliance has gotten support from anti-vaccination activists online and in the podcast world.

To recap: Neither credible scientific research nor credible medical professionals back ivermectin as a Covid-19 treatment, but its popularity is buoyed at least in part by the appearance of scientific backing in political and social circles where people distrust the government’s public health guidance.

This matters because it suggests that vulgar hostility to science isn’t the only culprit in communities resistant to the vaccines. There’s a desire, even among those on the fringe of mainstream beliefs about medicine, for technical information, insider knowledge and some kind of expertise. As the popularity of these physicians groups and large Facebook groups such as “Ivermectin MD Team” imply, the desire to opt out of mainstream public health norms doesn’t mean that everyone opposed to the vaccines fails to appreciate the dangers of Covid-19. It means that there’s a search for an alternative solution to the government-backed vaccines —which requires turning to sources who have perceived ideological credibility.

This has substantial implications for how we go about trying to persuade those resisting the vaccines. Calling for scientific rigor is always appropriate, but there’s also the task of getting people to trust the institutions who are credibly conducting, regulating and disseminating scientific research. And that’s a much heavier lift: Trust in major institutions — and one another — has been declining in American society for many years. One outcome of that mistrust is that people reject government or mainstream media accounts of problems and turn increasingly toward in-groups to find solutions to things — even if that means downing toxic levels of horse dewormer.