Doctors deal with requests for unproven treatment

State medical board won’t take stance on use of anti-parasite drug.

Ginger Bridgers, sick with COVID19 in January, asked her doctor for the drug she’d heard so much about, ivermectin. Her doctor turned her down, saying there was no reliable research the anti-parasite drug could help.

When Bridgers’ sister, Emily Oglesby, went to the hospital in July with frightening symptoms of COVID-19, though, she and her husband were both sent home without being admitted — but with prescriptions for ivermectin.

As demand for the drug skyrocketed in August, a handful of Georgia physicians have been writing prescriptions for those who request it — or even offering it for patients to try, as they scramble for ways to treat COVID-19.

Those doctors are doing so against the advice of the Food and Drug Administration, the American Medical Association and the American Pharmacists Association. Even the

drug’s manufacturer, Merck, put out a statement emphasizing it had seen no data showing ivermectin helped COVID19 patients as well as “a concerning lack of safety data in the majority of studies.”

Those concerns, misinformation about the drug’s effectiveness and growing reports of people being poisoned have prompted some licensing authorities to advise against using it and a few states to file complaints against doctors who are prescribing it. But the Georgia medical board told The Atlanta Journal-constitution it has no stance on the drug. Nor has the board provided any guidance to doctors or the public about ivermectin.

That leaves it to Georgia doctors whether or not to prescribe the medication, and for those who take it to be the test subjects.

The medical board’s chairwoman, Dr. Debi Dalton, did not respond to the AJC’S request to discuss the board’s stance.

Ginger Bridgers doesn’t know whether her sister and brother-in-law requested ivermectin after they went to Burke Medical Center in Waynesboro. She doesn’t know how much of the drug they took.

And she can’t ask them. Her sister went home and was dead a few days later. Her brother-in-law was transported to Augusta and died there.

If ivermectin was to be the cure, it didn’t save their lives.

Poison center calls spike

A veterinary version of ivermectin is used in livestock as a dewormer, while the FDA has approved ivermectin tablets to treat people for conditions caused by parasites, such as lice or river blindness. Because it is federally approved for that use in humans, doctors can legally prescribe it “off label” for other reasons, too.

Pandemic and vaccine skeptics from podcast stars to the outcast group America’s Frontline Doctors have taken it up as a cause.

That prompted a stampede for the drug. The prescription tracking firm IQVIA showed an increase from an average of about 3,600 prescriptions a week before the pandemic to 88,000 for the week ending Aug. 13, the last date for which data is available.

That in turn has triggered a surge of calls to poisoning centers by people who overdosed on tablets or who self-administered the veterinary form of the medication, which is formulated for bigger animals, like cows and horses, that can handle amounts a person cannot.

The Centers for Disease Control and Prevention has reported cases in which patients were hospitalized with hallucinations, disorientation and tremors. Poison control centers said among the calls they’ve received are a small number by people encountering “death and major effect.”

At the Georgia Poison Control Center, calls about ivermectin poisoning increased from an average of about five per month from January through July of this year to 32 in August.

Dr. Robert Geller, the Georgia Poison Control Center’s medical director, said he was concerned that the pandemic has led to a breakdown in trust with medical authorities.

“I have concerns that people are feeling anxious and the need to be skeptical or critical or concerned about the advice they’re getting from organized medicine leaders,” Geller said. “And that’s concerning that we’re in that position.”

He wants people to be careful.

“This is definitely not a drug in which if some is good, more is better,” Geller said. “You can take too much and get sick from it.”

Flawed studies

There are studies underway about whether the drug has antiviral properties that would be effective against COVID-19. But research cited so far on ivermectin’s benefit with COVID-19 is not reliable.

The studies have been small, and many lacked rigorous safeguards. One rare large study showing major benefits was recently withdrawn from the computer server that hosted it because of concerns about the data, including questions of plagiarism and research subjects who appeared from documents to be deceased at the time they were allegedly testing out ivermectin. The study author said he wasn’t given a chance to defend the paper.

It’s important that drugs be proven effective before doctors give them to patients, said Dr. Peter Lurie, president of the watchdog group the Center for Science in the Public Interest.

“The compulsion to act is very powerful and I totally understand it,” Lurie said. “But the fact is that the history of medicine is littered with examples of well intentioned physicians who thought it was better to do something than not. And there are bodies to show for it.”

That’s why, Lurie said, it’s important for medical boards and other medical authorities to speak out about using ivermectin without studies that show it is safe and effective.

“I think it’s a cop-out,” he said, when medical boards don’t give advice on doctors’ use of ivermectin with patients infected with the coronavirus.

Lurie and other experts say they are also concerned that prescribing ivermectin will give a false sense of accomplishment, diverting medical authorities and patients from the need to do things that are shown to work.

Bridgers suspects that’s why her sister and brotherin-law were sent on their way with ivermectin, instead of getting care that might have saved their lives.

She wants Burke Medical Center on notice.

The hospital did not respond to the AJC’S repeated requests for comment.

“I mean, they’re just writing prescriptions for, just to be writing them,” Bridgers said.

She added, “Don’t take ivermectin. I mean, it’s just, you just don’t know.”

COURTESY OF GINGER BRIDGERS Emily Oglesby died on Aug. 1 after being prescribed ivermectin and another drug for COVID-19 at Burke Medical Center in Waynesboro. Her husband also died of COVID-19.