UTTAR PRADESH, INDIA – Last Friday, the State government of Uttar Pradesh announced that 33 districts in the state are at zero active cases of COVID-19, and 67 districts had not reported any new cases in the past 24 hours.

In total, the state had 199 active cases, with a total estimated population of over 202 million people (as of 2012). The positivity rate, the State confirmed, is at 0.01%, while the recovery rate is holding at 98.7%.

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As of early August, a senior official told The Times of India that 31.3% of the eligible population in the state has taken at least the first dose of a vaccine, and 5.8% of the population was considered fully vaccinated. They also reported an expected uptick in second doses in August.

With such a low vaccination rate, the State has pointed to its early use of Ivermectin as having kept cases and the death rate low.

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The Indian Express reported in May that Uttar Pradesh had been giving Ivermectin to patients both as a way to prevent disease and as a way to treat it.

“Uttar Pradesh was the first state in the country to introduce large-scale prophylactic and therapeutic use of Ivermectin,” Uttar Pradesh State Surveillance Officer Vikssendu Agrawal said. “In May-June 2020, a team at [the City of] Agra, led by Dr. Anshul Pareek, administered Ivermectin to all RRT team members in the district on an experimental basis. It was observed that none of them developed Covid-19 despite being in daily contact with patients who had tested positive for the virus.”

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Agrawal also said that the state engaged in contact tracing as well as surveillance (although he didn’t describe what he actually meant by “surveillance”).

“Despite being the state with the largest population base and a high population density,” he said, “we have maintained a relatively low positivity rate and cases per million of population.”

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The first wave of COVID-19 cases started in May of 2020 when a family of five traveled to Italy and brought it back to India with them.

Government doctor Anshul Pareek recommended the use of Ivermectin for the prevention and treatment of COVID-19.

“Soon, said Agra District Magistrate Prabhu N Singh, “the virus spread, with a large number of police personnel getting affected. Doctor Pareek approached me with a request to introduce Ivermectin on an experimental basis. I was told there are no risks involved with the use of the drug.”

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Singh said, “We introduced [Ivermectin] for three days, 12 mg as advised in the national guidelines at the time, followed by tests on the fourth or fifth day. We introduced it in the jail as well and the results helped us reduce positivity to a great extent, following which Additional Chief Secretary Health Amit Mohan formed a committee to access its usage and it was finally introduced in the state’s Covid management protocol in 2020 itself.”