The great horse paste debate.

"Hey Doc, are you a Democrat or a Republican?"

This may seem like a bizarre question to ask your doctor. What would their political affiliation matter in the treatment of your medical issues?

One emergency care physician in Montana, overwhelmed with COVID-19 cases in her ICU, recently reported being asked that very question by a patient.

"I am your doctor," Dr. Sara Nyquist said she told the patient while talking to a local news outlet Missoulian.

"You do wonder how we got here," she pondered.

But, we really don't have to wonder. We are in an era of political polarization. And social media is fanning the flames. With the COVID-19 pandemic, there's heated debates on Facebook, Twitter, and everywhere else you frequent online concerning people passing on getting a life-saving vaccine and instead consuming horse paste they purchased from their local animal feed store.

On social media, medicine is political now.

The horse paste debate
In early September, podcaster Joe Rogan announced that he had COVID-19. The popular yet controversial host posted a video to his Instagram account sharing the diagnosis, preceded by a list of medications he was taking to fight it.

One of his treatments: Ivermectin, a Nobel Prize-winning antiparasitic medication long used to treat roundworms and other parasites.

While Ivermectin is widely used in developing nations to treat humans, another version of the same drug is more commonly used as a dewormer for livestock. In order to get horses to take the medication, it comes in paste form, available to purchase at animal feed stores.

Yet, in recent months, anti-vaxxers and other COVID skeptics are heralding Ivermectin as a COVID-19 miracle cure – something it is not.

In fact, both the FDA and CDC have specifically put out statements explicitly warning against using Ivermectin to treat or prevent COVID-19. Merck, the major manufacturer of Ivermectin in the U.S. has also put out a statement against using the drug for COVID-19. When reached for comment, Merck directed Mashable to the same statement.

Because many medical professionals will not prescribe Ivermectin as it is not viewed as a treatment for COVID-19, some have been using the horse paste version as a workaround.

For months, the internet has been riddled with Facebook Groups and other online forums full of anti-vaxxers dedicated to taking the horse paste version. You'll even find people in these online groups discussing their daily "regimen" of ingesting Ivermectin horse paste as a preventative against getting COVID-19 in the first place.

Poison control centers warned of a surge in calls reporting Ivermectin overdoses from people taking the version meant for farm animals. The FDA even put out a statement explicitly telling people to stop taking horse paste.

Then, on social media, the Ivermectin situation really blew up when Rogan announced he was taking it after testing positive for COVID-19.

Rogan had previously told his young listeners they didn't need the vaccine. He had been spreading various COVID-19 conspiracy theories throughout the pandemic. In fact, months before his Instagram video, he even hosted prominent Ivermectin promoters – one of them being Dr. Pierre Kory of the Front Line COVID-19 Critical Care Alliance (FLCCC) – on his show to discuss the drug.

However, the Ivermectin mention in his Instagram video is what really caught on and set off a firestorm online.

Rogan, for his part, says that the Ivermectin he took was for humans and prescribed by a doctor, meaning he didn't eat horse paste.

The push for a "miracle cure"
Some developing nations, with nowhere else to turn and plentiful with Ivermectin, decided to experiment with the drug as a COVID-19 treatment as cases spiked. Without any real rigorous studying or legitimate data, word of Ivermectin's success in treating COVID-19 in those countries quickly spread amongst those seeking alternative treatments.

The FLCCC, an organization of medical professionals led by its founder Dr. Pierre Kory, soon became Ivermectin's strongest backer as a COVID-19 treatment in the U.S.

In fact, that may be an understatement.

Those who believe Ivermectin is a "miracle cure" for COVID-19 often cite Kory because he's called it a "miracle cure" himself – in his testimony in front of a Congressional committee no less. There is no evidence that backs him up.

The FLCCC was formed in the earliest days of the pandemic in March 2020. It was unclear as to how doctors should treat COVID-19 patients who were flooding hospitals when the virus first hit the U.S. Kory, a former critical care specialist, formed the FLCCC in order to develop ways to treat these patients.

Dr. Eric Osgood MD, an internal medicine doctor who treats COVID-19 "long haulers" – those who still experience debilitating symptoms and ailments even after overcoming the virus – became involved with the group because of their work.

In a conversation with Mashable, Osgood says he initially joined the FLCCC because they were "forward thinking doctors who were able to get ahead of the profession" on a few hospital treatments for the coronavirus, such as the use of blood thinners on COVID-19 patients.

However, Osgood left the organization earlier this summer. The reason? The insistence of the FLCCC, led by Kory, to promote Ivermectin over life-saving COVID-19 vaccines.

"We have vaccines now that are widely and easily available that are overwhelmingly shown to save lives," Dr. Osgood told me. "The group's influence is not being used to help people get over their fears and uncertainties about vaccines."

A look at the FLCCC website finds scant mention of the COVID-19 vaccines, let alone any promotion of them. However, Ivermectin enjoys a spotlight role as an entire website topic right on the FLCCC homepage's main menu at the top of the page. It sits right alongside the website's "About" and "FAQ" page.

Osgood is perhaps one of the most important voices in the Ivermectin conversation. He is not against the use of Ivermectin in COVID-19 patients. He claims he has seen its effectiveness in treating certain symptoms in these patients, acting an anti-inflammatory, for example. The New Jersey doctor believes that we'll know more about the possible benefits of Ivermectin use in COVID patients once there is a big enough trial. And, based on that data, he's also open to being wrong.

"I'm deeply uncomfortable with how Ivermectin is being treated as settled science [by the FLCCC] as opposed to making arguments based on data, risk, benefit, costs, burdens, lack of effective outpatient alternatives," he explained.

"It's not a miracle cure and it's not a vaccine alternative."

The polarization of COVID-19
Political polarization in the United States, exacerbated by social media, is not a new phenomena.

But the polarization of medical treatment? That is new.

Osgood tells Mashable that he's never seen anything quite like it in the world of medicine. That is until then-President Donald Trump wholly backed another so-called experimental miracle cure, hydroxychloroquine, at the beginning of the pandemic.

Despite criticism from medical professionals, right wing-leaning COVID skeptics quickly latched on to Trump's claims. Foreshadowing the current horse paste debacle, some people even took the wrong type of hydroxychloroquine, with fatal results.

Trump even found a group of fringe doctors who supported him to back up his claims. Those same fringe doctors, known as America's Frontline Doctor's, are now writing Ivermectin prescriptions for people seeking out the drug.

Studies would later confirm critics' claims about the ineffectiveness of hydroxychloroquine. But, to right wingers and anti-vaxxers, anyone who criticized hydroxychloroquine was making a political statement, not a scientific one.

And much in the same way it works with political discourse, these anti-vaccine conspiracy theorists were able to use social media to their advantage. They utilized filter bubbles within Facebook, Twitter, YouTube, and other platforms which enabled them to double-down on false claims about miracle cures and vaccines.

Conspiracy theories are everywhere now
Anti-vaxxers and conspiracy theorists have existed long before COVID-19.

Throughout the pandemic and during the early lockdowns, as a confused public searched online for answers, those very anti-vaxxers and conspiracy theorists were ready to meet them with their falsehoods.

Right-wing conspiracies like QAnon flourished during the pandemic. QAnon followers spread their false claims about COVID-19 being a hoax and mixed it in with their conspiratorial foundational beliefs, like Trump's political enemies running global trafficking rings.

As of the publication of this piece, there have been more than 684,000 COVID-19 deaths in the U.S. since the beginning of the pandemic. More than 2,000 people in the country are dying per day from the virus.

It didn't take long for conspiracy theorists to convince people on social media that COVID-19 was created by Trump's rivals, solely meant to cost him the presidential election. And from there the vaccinations – the very same ones Trump has taken credit for – became a way for President Joe Biden's administration to track people via 5G nanochips. (Of course, that is not true. There is no 5G chip in the COVID vaccine.

With Trump supporters, anti-vaxxers, and other conspiracy theorists officially controlling the COVID-19 narrative among their social media followers, they seek out bogus miracle cures like Ivermectin.

And then the problems eventually jump offline too.

In Idaho, one doctor recently recalled how a COVID patient's son-in-law threatened her life for not using Ivermectin. Earlier this month, a Chicago hospital was inundated with calls from QAnon believers, harassing the doctors for not using the drug to save a prominent conspiracy theorist sick with COVID-19.

The problem will continue
Ivermectin promoters like Dr. Kory have long promoted a few studies that claim to show the benefits of using the drug on COVID-19 patients.

However, as time has gone on, these studies have been pulled due to ethical concerns and faulty data.

Dr. Osgood described some of the studies on Ivermectin and COVID-19 that were out there as "flawed," "fabricated," and "done in a manner that is not in keeping with scientific standards."

"There has always been research fraud but never have I really seen such extreme amounts of fraud and scientific misconduct surrounding one drug," he told Mashable.

Even Ivermectin's online detractors have fallen for online misinformation, too, due to how polarized the issue is. A dubious study claiming Ivermectin lowers male sperm count quickly spread online over the past few weeks, even after it was debunked.

COVID-19 cases continue to rise in the U.S. Those who are hospitalized and die from the virus today are primarily the unvaccinated. Yet, stumble upon any anti-vaxxers Facebook profile and you'll find them proudly sharing conspiracy theories about COVID-19 and the vaccines.

Over on Reddit, a new community called "The Herman Cain Award" has emerged. The award is named after Herman Cain, a former Republican presidential candidate who attended a Trump rally during the pandemic and refused to wear a mask. He died of COVID-19, which he contracted from the event.

On this subreddit, users share screenshots of unvaccinated social media users' online posts – image after image of the anti-vaxx user declaring that COVID-19 is a hoax or the vaccines to be some secret government monitoring plot.

And then, last but not least, what some Redditors have come to call "the money shot," the post that earns that user "The Herman Cain Award": The final Facebook post, many times from a family member declaring that the unvaccinated poster has passed away due to COVID-19.

During my discussion with Osgood, I pointed to a recent report about how researchers discovered a molecule in the venom of a Brazilian viper that could possibly be used to fight COVID-19.

I joked about how I guess we'll soon see anti-vaxxers purposefully getting bit by venomous snakes.

A few days alter, Osgood sent me a link to a piece about how the unvaccinated are drinking iodine to fight COVID-19 now, undoubtably due to misinformation spread on social media. To Osgood, much of what we're seeing is a way for contrarians to buck the system. What better way to bother the establishment than to go against officials during a pandemic?

"The snake venom is coming, my friend..." he said.

Sure, healthcare has always been political, especially in the United States of America, the only industrialized nation without universal healthcare. And, no question, there's plenty of criticism to be level at the big pharmaceutical companies and their government lobbying to protect their profits.

Medical treatment, however, has typically not been a politically polarizing issue.

But here we are.

The FLCCC did not respond to Mashable's request for comment.