OPINION

Best is not enough

Re: "One man alone can't solve Covid crisis," (OpEd, May 10).

Klong Toey is home to 80,000 people, with conditions near-ideal for a super-spreader event: unsanitary slums, severe crowding making social distancing impossible and residents working all over Bangkok. Klong Toey already has Covid cases, yet Gen Prayut only ordered City Hall to test 20,000 people at 1,000/day. This will take 20 days at best. During this time, people are free to move at will, taking Covid to their employers city-wide.

Say, as is likely, there is a large number of cases. To achieve herd immunity by vaccinating 70% of the slum's remaining dwellers will take 42 more days at the present targeted rate -- plus added cases from allowing freedom of movement during vaccination. If the BMA locks the area down, it'll have to sustain the residents in every way, for these low-income families have no remaining savings to speak of.

Is this the humble best that Gen Prayut -- having gathered all the power from his ministers -- can do?

Re: "A pill overlooked," (PostBag, May 9).

PFM is wrong to say that Ivermectin has "gained acceptance as an alternative medical treatment for Covid 19 patients". There have been some clinical trials involving its use as a prophylactic to prevent Covid-19. The WHO does not recommend the use of Ivermectin except in clinical trials. The US FDA has not authorised its use, and strongly advises against it. The position of the European Medicines Agency is the same as that of the WHO.

It would be highly risky for anyone to take Ivermectin without medical supervision, and I'd be surprised if any Thai doctor would authorise its use as prophylactic given the possible side effects. It would also need to be approved by the Thai FDA. I doubt that body has authorised its use as a prophylactic or treatment for Covid 19 given the position of the WHO.

I am summarising the results of my research on the internet. I should stress that I am not a medical practitioner, but I suspect neither is PFM.

In his letter of 9-May "A pill overlooked", PFM says of Ivermectin that it "appears in many studies to prevent deaths and reduce the effects of Covid-19". Michael Setter (BP, May 11) says Ivermectin is "not only a proven effective treatment but also an effective prophylactic which protects against the Covid virus with very few side effects".

Both of these statements are rather misleading. I have been unable to find any clinical trials that show this drug to be effective against Covid-19. Most of the evidence appears to be anecdotal and a "study" by Surgisphere was retracted after its Covid-19 data was found to be largely unreliable.

The World Health Organization (WHO) and European Medicines Agency (EMA) advise that Ivermectin should only be used in clinical trials. Even the drugs manufacturer MSD says there is "no scientific basis for a potential therapeutic effect against Covid-19 from pre-clinical studies", "no meaningful evidence for clinical activity or clinical efficacy in patients with Covid-19 disease" and "a concerning lack of safety data" in most studies.

By all means have proper clinical trials of possible treatments, but lets not jump the gun and declare any drug to be effective until proven data exists.