Ivermectin's in vitro activity is real, but that's not the bar for medical treatment. The human body isn't a petri dish. A drug's effect in a lab doesn't account for how it's absorbed, distributed, metabolized, or excreted. That's why we don't treat cancer with compounds that kill cancer cells in a dish — the body's complexity breaks the link. Ivermectin's mechanism might be sound, but the real world doesn't care about theory. It demands results that hold up under the messy, unpredictable conditions of human biology.