The best study to date on Ivermectin effectiveness is a meta-analysis of high quality RCTs using the GRADE method. Shows mortality reduction of 48%. Matches with this study. That's a moderate benefit. That's a ton of lives saved. However, one prevailing theory is: it reduces death because it gets rid of parasites. These studies often take place in India and now Brazil where parasitic infections are much more common than in Western Countries like the US. The parasite angle is one of probably multiple reasons Ivermectin works. For any of you interested in the very high quality meta-analysis: https://pubmed.ncbi.nlm.nih.gov/34145166/ And this research team made a rebuttal to the idiots saying he included a bad RCT (which they dropped from their list).