Hospitalizations, Mortality Cut In Half After Brazilian City Offered Ivermectin To Everyone Pre-Vaccine is a report summarizing the experience of  Itajai offering Ivermectin as a prophylaxis against the disease.  H/T Tyler Durden at zerohedge. The preprint study is Ivermectin prophylaxis used for COVID-19 reduces COVID-19 infection and mortality rates: A 220,517-subject, populational-level retrospective citywide. Excerpts below in italics with my bolds.

In Itajai, a Southern city of Brazil in the state of Santa Catarina, between July 2020 to December 2020, a citywide study was conducted involving 220,517 people. A total of 133,051 of these people (60.3% of the population) received ivermectin before being infected by COVID-19. A total of 87,466 people (39.7 %) did not receive or did not want to receive the ivermectin during the program, including its use for prophylactic, outpatient, inpatient therapeutical purposes, or after having COVID-19. The use of ivermectin was optional, based on the absence of contraindications, and given upon medical discretion. Due to the uncertainty of reinfection with COVID-19, subjects with a history of previous COVID-19 did not participate in the program, notwithstanding, they were still permitted to use ivermectin prophylactically

Baseline characteristics of the 9,956 subjects included in the above analysis are described in Table 1. Ivermectin users had a higher percentage of subjects over 50 years old (p < 0.0001), higher prevalence of T2D (Type 2 Diabetes) (p = 0.0004), hypertension (p < 0.0001), CVD (p = 0.03), and had a higher percentage of caucasians (p = 0.004), than non-users.

Of the 7,345 subjects with COVID-19, there were 232 hospitalizations (3.16% hospitalization rate). Of the 4,311 ivermectin users, there were 105 hospitalizations (2.43% hospitalization rate), while among the 3,034 ivermectin non-users, there were 127 hospitalizations (4.18% hospitalization rate), with a reduction in hospitalization rate due to COVID-19 of 42% (RR, 0.58; 95%CI, 0.45-0.75; p < 0.0001).

When the overall population is accounted for, the risk of dying from COVID-19 was 0.09% among ivermectin non- users and 0.05% among ivermectin users, with a reduction of 48% of the chances of dying from COVID-19 (RR, 0.52; 95%CI, 0.37 –0.72; p = 0.0001).

The report goes on to note that these positive results are conservative for several reasons. As shown above, persons electing to take IVM  were older and had co-morbidities, yet statistically faired better.  Secondly, the dose and frequency of ivermectin treatment was 0.2mg/kg/day; i.e., giving one 6mg-tablet for every 30kg. for 2 days every 15 days.  This is much less than protocols for sick patients.  Also, the IVM was self-administered and may have been used less than prescribed.  

When analyzed in populational, city level, irrespective of the the percentage of subjects that used ivermectin prophylactically, COVID-19 hospitalization rate decreased from 6.8% before the program with prophylactic use of ivermectin, to 1.8% after its beginning (RR, 0.27; 95%CO, 0.21 – 0.33; p < 0.0001), and in COVID-19 mortality rate, from 3.4% to 1.4% (RR, 0.41; 95%CI 0.31 – 0.55; p < 0.0001).

When compared to all other major cities in the State of Santa Catarina, where Itajaí is located, differences in COVID-19 mortality rate between before July 7, 2020 and between July 7, 2020 and December 21, 2020, Itajaí is ranked number one, and far from the second place. These results indicate that medical-based optional prescription, citywide covered ivermectin can have a positive impact in the healthcare system.