The most easily quantifiable way to describe the indefensible lack of “approval” for ivermectin in COVID-19 is to note the actual amount of supportive clinical trials evidence in COVID-19, both randomized (31) and observational (32), including more than 26,000 patients with the near majority of all studies finding at least some important benefit with treatment.
Then compare that evidence to the average amount of evidence relied upon to formulate the treatment guidelines of the Infectious Disease Society of America:
In a 2010 review of 65 of its most recent guidelines, the IDSA found that 50% of guideline recommendations were made without any trials evidence in support and were termed “expert opinion only.”
Another 31% of guideline recommendations were based solely on observational studies, while only 16% of all recommendations were based on at least one randomized controlled trial.
In other words, the number of legitimate clinical trials for ivermectin have been far superior to those for the IDSA’s treatment guidelines.
Furthermore, ivermectin was approved for the treatment of scabies by the World Health Organization based only on 10 randomized controlled trials, including 852 patients. Despite the fact that these trials found ivermectin inferior to the cream it was being tested against, it still won approval due to its low cost and ease of administration.