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At least two states in India have turned to ivermectin to help manage their COVID-19 outbreaks, even as experts warn against doing so.

Goa, a tourist haven on India's west coast, and Uttarakhand, a northern state in the Himalayas, will use the anti-parasitic preventatively, giving it to wide swaths of their population in hopes of preventing future outbreaks.

Leaders of both states said their recommendations were evidence-based. "An expert medical panel has recommended this," Om Prakash, chief secretary of Uttarakhand, . Vishwajit Rane, health minister of Goa, also said an expert panel from Europe found the drug shortened recovery time and reduced the risk of death, according to the news agency.

But the drug's efficacy for COVID-19 has not been proven in a large randomized controlled trial, and no prominent health group -- the NIH and among them -- has recommended the drug in treatment or prophylaxis.

Madhu Pai, MD, PhD, professor of epidemiology & global health at McGill University in Montreal, a link to developed by collaborators in the U.K. and India, led by Cochrane and Christian Medical College Vellore in the southern state of Tamil Nadu.

On May 15, the group updated their guidance to state that it recommends "against using ivermectin for treatment of patients with any severity of COVID-19. Ivermectin should only be used in the context of a randomized controlled trial."

An author on that guidance has not returned a 番茄社区app request for comment.

Officials in Goa said the state will give ivermectin tablets to anyone older than 18. The tourist destination has remained open to vacationers through most of the recent COVID surge, and only imposed a 15-day lockdown last week.

Uttarakhand plans to distribute the drug even more widely, giving it to anyone over age 2, with the exception of pregnant and lactating women, according to Reuters. The state has been struggling with high caseloads, which rose from under 300 a day in early April to more than 7,000 per day last week, the news agency reported.

The state recently hosted a large festival called Kumbh Mela, which drew millions of people from across the country for a 2-week celebration. Reports noted little mask wearing or social distancing.

It didn't take long for ivermectin advocates to seize on the moves by these two states. The Front Line COVID-19 Critical Care Alliance, which has long championed the drug, paid little attention to the difference between causation and correlation in a : "Case counts and deaths are falling in India! A close look ... shows that the declines occurred as the Health Ministry [sic] began its widespread distribution of #ivermectin."

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