It is correlation AND causation. Several meta analysis all support Ivermectin. ( even when including the horribly done studies) Real world results in Utarh Pardesh, Indonesia, Japan, many African nations etc, STRONGLY support Ivermectin. The real world results when practiced broadly within a contained community ( a village, a city, a nation) were MORE effective then limited studies. Why? Because they crushed the disease, the broke the RO way below 1, and the virus died. The correlation is strong, the results global, the pathology known.