I’ve read more than one story about spouses or relatives insisting that a hospital treat their COVID-suffering loved one with the dewormer despite a lack of evidence that it works. Could the hospital simply have them sign some form that absolves the hospital et al of responsibility and go ahead with it? I just feel bad for deeply misguided people who go thorough getting a lawyer, a “good” doctor who agrees with them, and a whole expensive process for something that just won’t work and waste the hospital’s time?
I would say medical ethics would get in the way if ivermeticin has harmful side effects. Last time I looked it was recommended by the WHO only as part of a study, Perhaps the hospitals could put forth such a study and allow patients to sign up for it. At the very least the placebo effect may help a few as the placebo effect actually has been proven to work (though it’s implementations are usually unethical as you usually can’t tell someone they are getting medicine but give them nothing)
Our hospitals are overwhelmed by covid patients and barely hanging on as is. The last thing they need to do is a study on a drug that has no good evidence of being effective against covid.
Arguing against my own post: they might as well just let the spouse or whoever inject bleach if they think it will help. Why have a hospital at all? /s
That’s basically it. The conversation feels weird because even reasonable people have become saturated with the idea that maybe ivermectin isn’t a loony treatment idea.
Relatedly, what latitude does a patient have in determining the course of treatment among from among progressively more-invasive viable options? If my doctor tells me that a surgical procedure is a highly effective possibility but should be a last resort, can I tell him “screw it, cut me open!” Would an ethical doctor turn me away, or will the hospital do it so long as I’m willing to pay for it as elective surgery, since my insurance certainly wouldn’t cover it?
Last thing they need? Meaning that all the family and friends, patient advocates, law suits, and so-called experts insisting their their patient needs ivermeticin, is better then just having the patient study?
Yes. Because there are really very few such lawsuits etc. per medical institution/hospital. The number is trivial. While your alternative, having each hospital do its own ‘study’ is a HUGE resource sink, diverting staff from actually caring for patients. For absolutely no good reason other than to placate the fighting ignorants.
There’s a sort of vignette that helps put this issue in stark relief.
Michigan’s Henry Ford Hospital system did a study that showed significant reduction in mortality in COVID patients given Hydroxychloroquine.
But the flaws in the study were quickly pointed out very publicly.
When Henry Ford Hospital then sought to commence a prophylaxis trial, testing whether Hydroxychloroquine might reduce the incidence of COVID in front-line health care workers, et al, they couldn’t get enough volunteers to conduct the trial.
The fact that we have HC workers who choose to get fired rather than get vaccinated pretty much means that HC workers aren’t a monolith, but a pretty strong case could be made that – in aggregate – nobody put enough stock in Hydroxychloroquine to bother participating in the proposed prophylaxis study
With Ivermectin, there was, apparently some evidence that covid patients in some studies had a benefit. A recent meta-analysis correlated the studies showing a benefit as lining up with places where parasitic infections treatable with Ivermectin are endemic. In other words, there is probably a real, beneficial, effect in patients with covid and worms.
But unless the hospital is presented with evidence that the patient has such a condition, yeah, they are likely ethically bound not to subject a covid patient to a risk with no potential benefit.
Further to what @Qadgop_the_Mercotan has said, perhaps it’s better to expend some resources on a test case and setting a definitive legal precedent (to the extent that’s possible), rather than establishing a precedent that in every such case the hospital should take the short-term path of least resistance and waste resources on accommodating useless studies. Even if these morons will never learn, in principle the legal system is designed to learn.
Nobody ever starts with human studies. You’d have to have at least some reason to expect a treatment to be effective before any ethics board would ever approve a human study. And there’s no reason whatsoever to expect ivermectin or hydroxyquinine to be effective against covid.
BUT: FDA approved drugs constantly get prescribed for non-approved reasons (off label use). In fact, some drugs are MOST useful and most prescribed for conditions they were not originally intended for or approved for. And there’s nothing barring folks from gathering data on how that works out. Gabapentin rarely ever gets prescribed for its approved use anymore (seizure control). 99% of its scrips are written for off label diagnoses, and there’s a lot of studies done on it for said uses.
But even so, making hospitals do it for ivermectin or plaquenyl to pre-empt lawsuits or patient complaints remains a waste of time and resources.
If doctors prescribe, or hospitals administer, ivermectin for covid – or any drugs for off-label use – then who pays? I’d be surprised if any insurance would cover it.
Is that really an issue for ivermectin? It’s not expensive, the cost is a rounding error when you’re paying for a hospital bed. For an experimental cancer drug or something, of course it could be a huge cost.
My doctor prescribed it as a prophylactic during the height of the pandemic. My Aetna insurance covered it; 90 days for $3 at CVS – dosing instructions did not mention what is was for on the prescription bottle, only how many to take. BTW, upon being tested for antibodies it turned out I had already had Covid – only had a cough for a while, no other symptoms.
@Chronos “And there’s no reason whatsoever to expect ivermectin or hydroxyquinine to be effective against covid.”
There are over 100 studies that say it is. (One of them was retracted.) IMHO, the often repeated statement here that ‘there is no evidence it works for Covid’ is a political statement, not a scientific one. (Referring to ivermectin, not hydroxyquinine.)
Here’s the current consensus of the science-based medical community on ivermectin:
" As with other interventions that do not have a clear benefit, we recommend that ivermectin not be used for treatment of COVID-19 outside a clinical trial. Several meta-analyses have highlighted that the effect of ivermectin in patients with COVID-19 remains uncertain because of a lack of high-quality data [128-131]. As an example, in a July 2021 meta-analysis that identified four trials comparing ivermectin with placebo or standard care in outpatients with mild COVID-19, there was no clear reduction in all-cause mortality at 28 days (RR 0.33 in two trials, 95% CI 0.01-8.05), no reduction in need for invasive mechanical ventilation at 14 days (RR 2.97 in one trial; 95% CI 0.12-72.47), and no clear impact on symptom resolution at 14 days (RR 1.04 in one trial, 95% CI 0.89-1.21) [128]. The quality of the evidence for these outcomes was deemed low to very low because of imprecision and risk of bias. Although the meta-analysis also did not identify any increased risk of adverse effects with ivermectin, steep increases in calls to poison control centers about ivermectin toxicity compared with pre-pandemic rates have been reported [132,133]. Several of these calls involved ivermectin obtained without prescription (eg, from internet or veterinary sources); some patients were hospitalized for neurologic adverse effects related to uncertain dosages."
As a physician who trained as a medical scientist and who has been in practice for nearly 4 decades, this is the sort of information I consider authoritative, especially in view of how much junk science is out there.
SUMMARY: There’s no good scientific evidence that it helps. So don’t use it outside of clinical studies.
