Doctors claim Brazil hospitals gave dodgy COVID-19 care
Irene Castilho didn't even have a day to grieve after her husband died of COVID-19. She was sick, too, coughing and struggling to breathe; he was barely gone when she started using his oxygen mask. The same day, on March 22, she was admitted to a hospital in Sao Paulo.
The 71-year-old had followed doctors' instructions to the letter - dutifully taking her doses of hydroxychloroquine. She also took ivermectin and a battery of anti-inflammatories and vitamins in the so-called "COVID kit" that her health care company, Prevent Senior, mailed to her home. Still, her condition had deteriorated.
At the hospital, Castilho received dialysis and was intubated. When physicians consulted Castilho's daughters about giving her flutamide - a drug typically used for prostate cancer - they declined, worried about possible side effects for their mother who recently had liver cancer. They later saw a nurse administering flutamide; she told them it had been prescribed despite their objection.
Castilho died in late April, 33 days after her husband, and her daughters scattered her ashes upon his grave. "You know that passionate couple? That was them," her daughter Kátia Castilho told the Associated Press in a video call from northeastern city Joao Pessoa. "That's what keeps me from staying silent. That's what makes me unafraid. It's a truth that I wish were a lie. It's a wound that will never scar."
Castilho's case is one of a series of examples that have led to explosive accusations against Prevent Senior, which operates 10 hospitals in Sao Paulo, that have scandalized Brazil since mid-September. Whistleblowing doctors, through their lawyer, testified at the Senate last week that Prevent Senior enlisted participants to test unproven drugs without proper consent and forced doctors to toe the line on prescribing unproven drugs touted by President Jair Bolsonaro as part of a "COVID kit."
Some senators have said it appears Prevent Senior falsified death certificates to omit COVID-19 as cause of death. Authorities are also investigating the complaints the company conducted research without proper permission. The case underscores the resilient rift in polarized Brazil over proper treatment of COVID-19 patients, with many in the nation - including the unvaccinated president - bucking global scientific recommendations. And there's concern that other providers likewise implemented dodgy policies.
Two weeks ago, Pedro Batista Júnior, Prevent Senior's executive director, testified to senators that doctors were free to make their own prescriptions for treatment of COVID-19 and said patients had freely agreed to take their COVID kits. In response to more than a dozen questions from the AP, Prevent Senior denied all wrongdoing, irregularities at its facilities or having conducted unapproved trials. It said all patients or family members consented before receiving treatment.
It didn't respond to questions about how many patients received the COVID kits. Brazil has a public health care system, though service is often subpar. Many middle-class Brazilians have private plans, but costs for the elderly are high.
Prevent Senior seemed to help fill that gap. It was founded in 1997 and grew among those who couldn't afford premium care; its monthly cost is about $300, half that of some competitors. The company has more than 500,000 clients, with an average age of 68.
Three doctors formerly employed by Prevent Senior George Joppert, Alessandra Joppert and Walter Correa de Souza Neto told television program "Fantastico" on Oct. 3 that doctors received instructions from company officials to prescribe hydroxychloroquine.
Until that interview, all had remained anonymous. Souza Neto repeated that assertion in Senate testimony on Thursday: "Between the end of March and April (2020), (Prevent Senior) instituted a protocol to prescribe hydroxychloroquine for patients. There was no autonomy for the doctor; it was mandatory."
The antimalarial has been given glowing endorsements by Bolsonaro and his allies, who are among few remaining global champions for the drug. While a few studies at the pandemic's onset suggested it might be promising, they were largely conducted in lab dishes, not people. Extensive worldwide research has long since found it to be ineffective and potentially dangerous for COVID-19.
The doctors also said they were told to prescribe ivermectin, an antiparasite drug whose effectiveness for COVID-19 remains unproven. The American Medical Association recommends against prescribing it outside of formal trials.
Both drugs are part of what President Jair Bolsonaro and his allies refer to as "early treatment" for COVID-19. The president defended "early treatment" as recently as Sept. 20 at the U.N. General Assembly.